To compare the effectiveness of single-layered and double-layered intestinal anastomosis

Abstract

Background: Intestinal anastomosis is a fundamental surgical procedure performed in
various gastrointestinal surgeries, where two ends of the intestine are joined together after a
resection.
Aim: To compare the effectiveness of single-layered and double-layered intestinal anastomosis.
Materials and Methods: A prospective, single-centre, double-blind, randomized controlled study was conducted within the Department of General Surgery to compare the outcomes of
two different techniques for intestinal resection and anastomosis. The study included both
emergency and elective procedures involving jejuno-jejunal, jejuno-ileal, ileo-ileal, ileo-colic,
and colo-colic anastomoses, as well as stoma closures. A total of 100 eligible patients who
underwent intestinal resection and anastomosis were randomly assigned to one of two groups.
The participants were then randomly allocated to undergo either a single-layer extramucosal
intestinal anastomosis (Group A) or a double-layer intestinal anastomosis (Group B).
Results: The duration for which the nasogastric tube remained in place was shorter in Group
A (2.3 ± 0.7 days) compared to Group B (3.1 ± 0.8 days), with a p-value of <0.001. The time
for the return of bowel sounds postoperatively was also faster in Group A (2.5 ± 0.6 days)
compared to Group B (3.4 ± 0.9 days), with a p-value of <0.001. Similarly, the first
postoperative bowel movement occurred earlier in Group A (3.1 ± 0.8 days) than in Group B
(4.2 ± 1.0 days), with a p-value of <0.001. On average, patients in Group A were discharged
after 7.8 ± 1.4 days, whereas those in Group B required 10.2 ± 1.6 days of hospitalization
(p<0.001).
Conclusion: We concluded that the single-layer anastomosis technique is superior to the
double-layer technique in terms of operative time, suture material usage, and cost efficiency,
without compromising patient safety.