Title: Single vs Double Layered Intestinal Anastomosis: A Comparative Study
Authors: Dr Shashirekha C A, Dr Arvind Ramachandran, Dr Sreermulu P N, Dr Mohan Kumar K, Dr Bhaskaran A, Dr Krishna Prasad P
DOI: https://dx.doi.org/10.18535/jmscr/v5i2.104
Abstract
BACKGROUND
Perforation peritonitis is a common surgical emergency in the Indian Sub-continent and tropical countries. Perforationcan be treated by resection anastomosis or by creating a temporary stoma and again creating anastomosis on a later date to maintain continuity of the bowel. Anastomosis can be done by various methods including staples and hand sewn methods. Hand sewn methods include single layered gastro-intestinal suturing (SGIA) and double layered gastro-intestinal (DGIA) suturing. The principles of intestinal suture was establishes more than a century ago by Travers, Lambert and Halsted. Single layer intestinal suture was a more contemporary innovation first described by Hautefeuille in 1976. This comparative study will help us to establish the criteria for instituting the management modality and outcome of these two procedures.
References
1. Brooks DC, Zinner MJ: Surgery of the Small and Large Bowel. Maingot's Abdominal operations. Edited by: Zinner MJ. 1997, Stamford: Appleton & Lange, 2: 1309-1310. 10
2. Lustosa SA, Matos D, Atallh AN, Castro AA: Stapled versus handsewn methods for colorectal anastomosis surgery: a systematic review of randomized controlled trials. Sao Paulo Med J. 2002, 120: 132-136. 10.1590/S1516-31802002000500002.
3. MacRae HM, McLeod RS: Handsewn vs. stapled anastomoses in colon and rectal surgery: a meta-analysis. Dis Colon Rectum. 1998, 41: 180-189. 10.1007/ BF02238246.
4. Friend PJ, Scott R, Everett WG, Scott IHK: Stapling or suturing for anastomoses of the left side of the large intestine. Surg Gynecol Obstet. 1990, 171: 373-376.
5. Thomson WHF, Robinson MHE: One-layer continuously sutured colonic anastomosis. Br J Surg. 1993, 80: 1450-1451.
6. AhChong AK, Chiu KM, Law IC, Chu MK, Yip AW: Single-layer continuous anastomosis in gastrointestinal surgery: a prospective audit. Aust NZ J Surg. 1996, 66: 34-36.
7. Brodsky JT, Dadian N: Single-layer continuous suture for gastrojejunostomy. Am Surg. 1997, 63: 395-398.
8. Law WL, Bailey HR, Max E, Butts DR, Smith KW, Thompson DA, Skakun GB, Graves E: Single-layer continuous colon and rectal anastomosis using monofilament absorbable suture (Maxon): study of 500 cases. Dis Colon Rectum. 1999, 42: 736-740. 10.1007/BF02236928.
9. Irvin TT, Goligher JC, Johnston D: A randomized prospective clinical trial of single-layer and two-layer inverting intestinal anastomoses. Br J Surg. 1973, 60: 457-460.
10. Everett WG: A comparison of one layer and two layer techniques for colorectal anastomosis. Br J Surg. 1975, 62: 135-140.
11. Goligher JC, Lee PW, Simpkins KC, Lintott DJ: A controlled comparison one- and two-layer techniques of suture for high and low colorectal anastomoses. Br J Surg. 1977, 64: 609-614.
12. Maurya SD, Gupta HC, Tewari A, Khan SS, Sharma BD: Double layer versus single layer intestinal anastomosis: a clinical trial. Int Surg. 1984, 69: 339-340.
13. Ordorica-Flores RM, Bracho-Blanchet E, Nieto-Zermeno J, Reyes-Retana R, Tovilla-Mercado JM, Leon-Villanueva V, Varela-Fascinetto G: Intestinal anastomosis in children: a comparative study between two different techniques. J Pediatr Surg. 1998, 33: 1757-1759. 10.1016/S0022-3468(98) 90279-2.