A Comparative Study of Single-Layered Versus Double-Layered Intestinal Anastomosis

Background: Intestinal perforations requiring resection anastomosis of the gastrointestinal tract (GIT) or the formation and closure of temporary intestinal stoma are prevalent worldwide. This prospective comparative study was done to assess the efficacy and safety of single-layered anastomosis compared to a double-layered anastomosis. Methods: Patients undergoing intestinal anastomosis with either of these two techniques were observed prospectively for various outcome parameters like time taken for anastomosis, and that for entire surgery, postoperative complications, etc. Data obtained were analyzed for statistical significance by applying the chi-square test and student's "t-test." Results: Duration for fashioning the anastomosis was significantly lesser for a single layer anastomosis than double (mean [+/- SD] for single layer was 19.57 +/- 2.25 minutes and for double layer group was 30 +/- 2.59 minutes, p=0.002). There was no statistical difference in the postoperative complications between the two groups. The postoperative incomplete intestinal obstruction was reported in three cases of the double layer group. Conclusion: Single-layered gastrointestinal anastomosis (GIA) resulted in a significant reduction in time, without any difference in complications. Additionally, it is easier to train surgical residents in the single layered technique which is particularly important in the setting of a teaching institute and can be recommended for intestinal anastomosis.