Shaukat Mahmood Mirza, Kamran Khalid, Faisal Hanif.
Single layer interrupted serosubmucosal intestinal anastomosis – An equally safe alternative.
J Coll Physicians Surg Pak Jan ;12(10):583-7.

Objective: Evaluation of the safety of single-layer interrupted serosubmucosal anastomosis and comparison with double-layer continuous technique in construction of various gastrointestinal anastomosis. Design: Prospective observational and comparative study between two techniques of anastomosis. Place and Duration of Study: Surgical Unit III of Jinnah Hospital, Allama Iqbal Medical College, Lahore, over a period of two years from October 1, 1999 through September 30, 2001. Subjects and Methods: Study comprised of two Groups (A and B) with 100 consecutive patients fulfilling the inclusion criteria and comparable variables. Single-layer interrupted serosubmucosal anastomosis constructed by one group of senior surgeons (Group A) was compared with two-layer continuous anastomosis performed by another team of senior surgeons (Group B). The safety of two techniques of anastomosis was analyzed comparing the outcome in terms of morbidity and mortality. Results: Overall anastomotic failure rate was 5%. The morbidity of Group A (12%) was significantly lower than that in Group B (22%). The rate of leakage of wound in Group A was 2% compared to 8% in Group B (p<0.05). Wound infection was observed in 12% of Group A and 22% of Group B patients (P<0.05). While there was no mortality in Group A, one death (2%) in Group B was attributed to anastomotic failure (p=NS). Conclusion: Single-layer interrupted serosubmucosal anastomosis shows a low incidence of anastomotic leakage and a significant avoidance of septic complications. The anastomosis is safe and effective at various sites of gastrointestinal tract.

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