Key result
Single layer extra mucosal anastomosis significantly reduced the mean duration required to perform the anastomosis compared to conventional double layer anastomosis (21.64 vs 29.6 minutes, p<0.001).
Why the study?
Does single layer extra mucosal anastomosis reduce operative time or complications compared to double layer anastomosis in patients undergoing laparotomy?
RCT (n=29)
Alternatively allotted
No
Does single layer extra mucosal anastomosis reduce operative time or complications compared to double layer anastomosis in patients undergoing laparotomy?
Absolute Event Rate: 21.64% vs 29.6%
p-value: p=<0.001
Single layer intestinal anastomosis is faster to perform than double layer anastomosis without increasing the risk of anastomotic leak or prolonging hospital stay.
Single-layer anastomosis shortens operative time with comparable leak rates; small Level 5 data leaves open any practice change.
Background: Gastrointestinal anastomosis has been a part of research since decades and is one of the key skills in surgeon’s armamentarium. This study compared the outcome of single layer anastomosis with double layer anastomosis.Methods: The study was designed as a prospective comparative study and 29 cases were included in the study during December 2016 to September 2017, who consented for being part of the study. Patients were alternatively allotted into the either group. Group A underwent single layer anastomosis and Group B underwent double layer anastomosis. Outcome parameters were analysed in the form of ‘duration required to perform anastomoses, ‘duration of hospital stay’ and ‘dnastomotic leak.Results: Mean duration required to perform anastomosis in Group A is 21.64±1.60 minutes and in Group B is 29.6±2.02 minutes. The difference between the mean duration required for anastomosis between the two groups were statistically significant (p<0.005). Mean duration of hospital stay in Group A was 12.35±1.72 days and Group B was 12±2.44 days (difference was statistically insignificant), 3 (10%) cases in Group A and 2 (6.8 %) cases in Group B developed anastomotic leak and the difference was statistically insignificant.Conclusions: Our study concluded that there is statistically significant difference between the single layer anastomosis and double layer anastomosis in terms of time taken to perform anastomosis, however there is no difference in postoperative anastomotic leak and duration of hospital stay.
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Sai et al. (2019) conducted an RCT in Bowel resection and anastomosis (n=29). Single layer extra mucosal anastomosis vs. Conventional double layer anastomosis was evaluated on Duration required to perform anastomosis (minutes) (p=<0.001). Single layer extra mucosal anastomosis significantly reduced the mean duration required to perform the anastomosis compared to conventional double layer anastomosis (21.64 vs 29.6 minutes, p<0.001).
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