Comparison of single-layer inverting, two-layer inverting, and everting anastomoses in the rabbit colon

Inverting methods of suture should be used in colonic anastomosis. A two-layer inverting anastomosis is usually recommended but it has been suggested that a single-layer technique is preferable and safer. Single-layer inverting, two-layer inverting, and everting anastomoses were compared in the unprepared rabbit colon. Everting anastomoses gave inferior results by comparison with both inverting methods with respect to tensile strength, anastomotic leakage, and histological evidence of healing, but no difference was found between the single-layer and two-layer methods using these criteria and measurement of colonic collagen. It was concluded that single-layer inverting methods of anastomosis had no particular advantages over the standard two-layer inverting method.