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Mihir, K. Shah, Keerthi, Ravikiran, and Parmar Sneha. "Comparative Study between Use of Single Layer Interrupted Extra Mucosal Technique versus Double Layer Continuous Technique in Intestinal Anastomoses." International Journal of Pharmaceutical and Clinical Research 15, no. 2 (2023): 612–19. https://doi.org/10.5281/zenodo.12818323.
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<strong>Introduction:</strong> The anastomotic approach chosen is based on the location of the anastomosis, the quality and caliber of the bowel, and the underlying medical process. However, personal surgical experience and inclination continue to play a significant role in the decision to conduct a specific anastomosis. The two-layer technique’s sole noticeable drawback is that it takes considerable effort and time to complete. Recent papers have advocated for a monofilament plastic suture-based single-layer continuous anastomosis. This anastomosis can be created more quickly, for less money, and with a potentially lower risk of leaking than any other approach. <strong>Aims and Objectives: </strong>To compare single layer interrupted extra mucosal technique versus double layer continuous technique in intestinal anastomoses. <strong>Methods:</strong> This was prospective randomized control trial carried out on admitted patients and posted for resection and anastomosis surgery. Subjects was divided into two groups by alternative technique, namely, Group A. Patients, who received Single layered interrupted extra-mucosal anastomosis and Group B patients, who received double layered continuous intestinal anastomosis. In double layer anastomosis, anastomosis done using a 3-0 polygalactin continuous suturing for inner mucosal layer and a 3-0 silk interrupted for outer seromuscular layer. Each bite included 4 to 6mm of seromuscular wall. All single layer extramucosal interrupted anastomosis are constructed using a 3-0 Polygalactin round body needle suture beginning at the mesenteric border. Stitch advancement was approximately 5mm. <strong>Results: </strong>In Group A (single layer) the range of time taken for closure was between 7.67 minutes to18.00 minutes and mean duration was 14.35 minutes to perform an anastomosis, in Group B (double layer) the range was between 16.83 minutes to 24.83 minutes and mean duration was 21.43 minutes to perform a double layered anastomosis per operatively. The mean difference between two groups was 7.08 minutes, t value was 11.9 minutes and p<0.001, which is highly significant. <strong>Conclusion: </strong>The study has concluded that single layer intestinal anastomosis requires much lesser duration than double layer intestinal anastomoses technique.
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Kushaldeep, Kaur, Singh Rekhi Harnam, Singh Rekhi Arshdeep, Kumar Mittal Sushil, and Singh Gurjot. "A Comparative Study between Single Layer Mucosa Sparing Versus Double Layer Intestinal Anastomosis." International Journal of Pharmaceutical and Clinical Research 16, no. 4 (2024): 1086–91. https://doi.org/10.5281/zenodo.11180851.
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<strong>Introduction:</strong> Gastro-intestinal anastomosis is one of the most commonly performed procedures in both the elective and emergency surgical theatres worldwide and such procedures are commonly performed to restore the gut continuity after resection of primary pathology or at times to bypass the same. A thorough knowledge of the principles of a good anastomotic technique is a pre-requisite to achieve good surgical outcomes for any surgeon dealing with abdominal surgeries. <strong>Material and Methods:</strong> 100 patients who required intestinal anastomosis were included in the study. These patients were divided into two groups- A and B with 50 patients each. In group A, intestinal anastomosis was done using single layer mucosa sparing technique. In group B, anastomosis was done using the conventional double layer technique. A comparison was made between both the groups in terms of per- operative and post-operative outcomes i.e., time taken for anastomosis, incidence of anastomotic leak, intra-abdominal abscess, sepsis, paralytic ileus, wound infection, mortality and duration of hospital stay. <strong>Results:</strong> Mean duration required for single layer mucosa sparing anastomosis was found to be significantly lesser than double layer technique (18.76+1.60 mins vs 28.88 + 2.02 mins). In terms of postoperative leak and other complications, double layer intestinal anastomosis offered no definite advantage of single layer mucosa sparing anastomosis with similar outcomes observed. <strong>Conclusion:</strong> Considering the duration of procedure and ease of completion, single layer mucosa sparing intestinal anastomosis may prove the optimal choice in most gastro-surgical situations.
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Pathak, A., MD Aklakhur Rahaman, and SM Mishra. "Single-Layer Versus Double Layer Intestinal Anastomosis of Small Bowel at Nepalgunj Teaching Hospital." Journal of Nepalgunj Medical College 12, no. 1 (2015): 35–38. http://dx.doi.org/10.3126/jngmc.v12i1.13405.
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Background: Resection and anastomosis of small bowel is one of the common surgical procedure encountered in routine and emergency cases. There are various techniques of anastomosing the resected intestine.Objectives: To know the efficacy of single layer anastomosis over double layer anastomosis in terms of anastomotic leakage, wound infection, mortality and time consumed.Methods: A comparative cross sectional analytical study was carried out at department of General Surgery at Nepalgunj Medical College Teaching Hospital, Kohalpur, Banke, Nepal from January 2013 to December 2013. Altogether 62 patients who underwent resection and anastomosis of small bowel were considered for this study. Patients who were included in this study were equally divided into two groups. Group A (n=32) underwent single layer anastomosis and group B (n=30) were subjected to double layer anastomosis. In both the groups anastomotic leakage, wound infection, mortality and time consumed were recorded and compared.Results: Altogether 62 patients were included in the study. The study showed anastomotic leakage 3 (9.37%) in Group A and 2 (6.67%) in Group B. Wound infection was 6 (18.75%) in Group A and 4(13.33%) in Group B and mortality was observed in only 1(3.12%) patient in Group A due to uncontrolled sepsis. There was no statistical difference between the two groups in anastomotic leakage, wound infection and mortality as shown by respective p (0.696, 0.562, 0.329) values. However the time required for single layer bowel anastomosis was less in comparison to double layer bowel anastomosis.Conclusion: Based on our data, the technique of single layer of bowel anastomosis does not increase the rate of anastomotic leakage, wound infection and mortality however time required for anastomosis is less as compared to double layer anastomosis. Therefore this study concludes that there is no added benefit of double layer of anastomosis over single layer bowel anastomosis.Journal of Nepalgunj Medical College Vol.12(1) 2014: 35-38
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Sai, K. Lohit, and C. Sugumar. "A comparative study of single layer extra mucosal versus conventional double layer anastomosis of intestines in elective and emergency laparotomy." International Surgery Journal 7, no. 1 (2019): 184. http://dx.doi.org/10.18203/2349-2902.isj20195966.
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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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Juhi, Singh, Nagar Anju, Meena Dharmraj, Meena Meenesh, and Meena Radheyshyam. "Comparative Study between Single vs Double Layer Intestinal Anastomosis." International Journal of Toxicological and Pharmacological Research 13, no. 11 (2023): 149–53. https://doi.org/10.5281/zenodo.10998829.
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<strong>Background</strong><strong>:</strong> In gastrointestinal surgeries, intestinal anastomosis is a routine and important process. While double layer anastomosis was once thought to be secure, several surgeons now contend that single layer anastomosis with non-absorbable suture yields comparable outcomes. <strong>Methods:</strong> A single-centre retrospective cohort comparative study was conducted in the Department of General Surgery, Govt. Medical College and Hospital, Kota, Rajasthan, India during April 2022 to June, 2023. A total of 50 patients were taken, out of which 35 underwent double layer anastomosis and 15 patients had single layer anastomosis. <strong>Result:</strong> A total of fifty patients were enrolled; thirty-five underwent double layer anastomosis and fifteen underwent single layer anastomosis. Accordingly, the patients in each group were matched for diagnosis, sex, and age. Both the length of hospital stay and the mean time required for anastomosis were significantly shorter in Group-A. Compared to the double layer group, the single layer group experienced a faster postoperative return of bowel function. The double-layered group incurred a comparatively higher cost for the suture material used. However, there was no significant difference in the complication rates between the two groups. <strong>Conclusions</strong><strong>:</strong> There is not much difference in development of complications in both the methods. Both have same efficacy, mean time taken return of bowel movements. A single layer requires less operating time and is more economical.
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Kumar, Ajit, and Vinod Kumar. "Single layer versus double layer intestinal anastomoses: a comparative study." International Surgery Journal 7, no. 9 (2020): 2991. http://dx.doi.org/10.18203/2349-2902.isj20203782.
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Background: There are still conflicting views regarding suitability of single layer and double layer anastomotic technique. This prospective single blinded randomized comparative study conducted at Rajendra Institute of Medical Sciences to assess various aspects viz. safety, efficacy, duration of hospital stays and chances of perforation in single- and double-layer anastomotic surgery.Methods: 26 patients each in single layer and double layer anastomosis group were included in the study. Single layer intestinal anastomosis was carried using extramucosal technique with 2-0 vicryl suture (round body). Double layer anastomosis was carried out using interrupted 3-0 silk lembert sutures for the outer layer and a continuous 2-0 vicryl for the inner layer. End to end colocolic, end to end ileocolic, end to side ileocolic, end to end ileoileal, side to side ileoileal, end to end jejunoileal and end to end jejunojejunal anastomosis were performed. Each group was compared for anastomotic leak, time required to construct the anastomosis, cost incurred, and length of hospital stay.Results: Findings of the study indicated that single layer is economical in comparison to double layer anastomosis and took significant less time to operate. There was no significant difference in hospital stay of the patients in two groups. There was no anastomotic leak in group-S (single layer) while one (3.8%) patient in group-D (double layer) suffered from anastomotic leak.Conclusions: It was concluded that single layer anastomosis method is beneficial and safe as it required less operative time, suturing material and no leak took place after surgery.
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Pawar, Tejaswini Murari, Ravikiran Hosur Ramamurthy, and Shashirekha Chikkavenkataswamy Anjaneyulu. "Single Layer Versus Double Layer Anastomosis of Small Intestine – A Comparative Study from Karnataka, India." Journal of Evolution of Medical and Dental Sciences 10, no. 30 (2021): 2300–2304. http://dx.doi.org/10.14260/jemds/2021/470.
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BACKGROUND Intestinal anastomosis is an operative procedure that is of importance in the practice of surgery. It is a very commonly performed technique in today’s surgical era. We wanted to study the postoperative complications like anastomotic leak and abscess formation and duration of hospital stay in single layer and double layer anastomosis and compare the same. METHODS In our prospective observational study, 80 patients were reviewed and were divided into 2 groups. Cases were allotted to either group based on the odd even method requiring single- and double-layer anastomosis, odd being single layer and even being double layer anastomosis. Intestinal anastomosis was carried out in single layer technique with delayed absorbable suture material and double layer technique with inner transmural layer with delayed absorbable suture material and seromuscular layer with non-absorbable suture material. RESULTS Each group had 40 patients, there was significant difference noted between the groups. Mean duration of hospital stay in single layer group was 17.85 ± 7.62 days and in double layer group was 26.20 ± 16.12 days (P = 0.043 *). In single group, mean time taken for anastomosis was 18.50 ± 1.73 and in double group was 29.05 ± 2.19. There was significant difference in time taken between two groups (P < 0.001). In single group, majority of subjects had no anastomotic Leak (95 %) and 5 % had leak. In double group 70 % had no leak and 30 % had leak. P value was statistically significant (P = 0.037). CONCLUSIONS Single layer anastomosis was better in terms of duration of hospital stay, postoperative anastomotic leaks and time taken for anastomosis. KEY WORDS Single Layer, Double Layer, Small Bowel, Duration of Hospital Stay, Anastomotic Leaks
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Gurung, Amar, Santosh Shrestha, Devendra Shrestha, et al. "A Comparative Study of Single Layer Versus Double layer Intestinal Anastomosis." Medical Journal of Pokhara Academy of Health Sciences 1, no. 2 (2018): 98–101. http://dx.doi.org/10.3126/mjpahs.v1i2.23403.
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Objective: To determine the efficacy of single layer intestinal anastomosis to double layer technique in terms of anastomotic healing.
 Materials and Methods: Fifty patients who underwent intestinal anastomosis in the Department of Surgery, Western Regional Hospital from June 2014 to May 2016 were taken for this comparative study and divided equally in two groups, 25 each (single layer and double layer).
 Results: Of the total fifty cases, twenty-five cases included in each group, there was no leakage in single layer group while 1 patient had leakage in double layer group which was statistically insignificant.
 Conclusion: Single layer interrupted intestinal anastomosis is simple to carry out and is as efficacious as double layer anastomosis in terms of postoperative anastomotic leak.
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Rai, Arvind, and Sukantth R. J. "Study of clinical outcome of patients undergoing intestinal anastomoses with single layer extramucosal technique and double layer anastomoses." International Surgery Journal 8, no. 9 (2021): 2572. http://dx.doi.org/10.18203/2349-2902.isj20213181.
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Background: Intestinal anastomosis is one of the common surgeries for cases like bowel obstruction, incarcerated hernias, benign and malignant tumours of small and large bowel. The ideal intestinal anastomosis does not leak and allow normal function of the gastrointestinal tract. This study compared single layer versus double layer intestinal anastomosis in terms of duration, postoperative complications like anastomotic leak.Methods: A total of 100 patients admitted in Hamidia hospital, based on history and clinical examinations and radiological examinations, placed in two groups, group A (single layer anastomosis) and group B (double layer anastomosis) and were operated by a qualified surgical specialist. Data analysis of anastomotic time, anastomotic leak was done and statistical tests of significance were applied. A p value less than 0.05 is considered as significant.Results: In group A (single layer) the time required to perform in 30 (60%) patients is between 16-20 minutes. In double layer, maximum were done in between 26 to 30 minutes, 32 (64%). In our study of 100 patients, there were 6 anastomotic leaks, of which four of them were in group A (single layer) and 2 of them in group B (double layer).Conclusions: In our study, the duration required to perform a single layer intestinal anastomosis is significantly lesser when compared to double layer. There is no significant difference in anastomotic leak between two groups. Less time with no difference in complications, a move towards single layer anastomosis should be preferred.
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Md Hakim Mia, Shib Shankar Kuiri, Kanchan Kundu, and Sayan Chakrabarty. "Prospective observational comparative study of outcomes between single-layer versus double-layer gastrointestinal anastomosis." Asian Journal of Medical Sciences 14, no. 10 (2023): 263–70. http://dx.doi.org/10.3126/ajms.v14i10.54858.
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Background: In elective gastric surgeries, gastrojejunostomy is the most common anastomosis being done in both benign and malignant conditions. Anastomotic leak, bleeding, wound infection, and anastomotic stricture are important complications associated with intestinal anastomosis. Both double-layer and single-layer anastomosis are well-established techniques for gastrojejunostomy. Till now, there are no definite concluding findings that determine the suitability of either technique. Aims and Objectives: To compare the utility of single-layer gastrointestinal anastomosis versus double-layer gastrointestinal anastomosis in terms of post-operative outcome. Materials and Methods: A hospital-based prospective comparative study was conducted in the department of general surgery BSMCH with a time frame of about 1/2 years. A total no of 52 patients of the adult age group (18–80 years) admitted in the department of general surgery underwent gastrointestinal anastomosis has been studied. Results: Twenty-six (50%) patients underwent single-layer gastrointestinal anastomosis. The rest 26 (50%) underwent double-layer anastomosis. There is no statistically significant difference between these two groups in terms of post-operative nausea vomiting (P=0.73419), wound infection (P=0.385332), anastomotic leak (P=0.552003), and pelvic abscess (P=0.4924). However, the duration of surgery (P<0.0001) and hospital stay (P=0.0179) was significantly less in single-layer gastrointestinal anastomosis. Conclusion: Double-layer gastrointestinal anastomosis offers no definite advantage over single-layer anastomosis in terms of post-operative complications. Considering the duration of the anastomosis procedure and hospital stay, single-layer gastrointestinal anastomosis may prove the optimal choice in most surgical situations.
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Warsinggih, Fardah Akil, Ronald E. Lusikooy, et al. "The comparison of anastomosis strength and leakage between double-layer full-thickness and single-layer extramucosal intestine anastomosis." Annals of Medicine & Surgery 85, no. 8 (2023): 3912–15. http://dx.doi.org/10.1097/ms9.0000000000001072.
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Background: Various intestine anastomosis techniques have been studied and used, but which is best is still debated. In our center, double-layer full-thickness intestine anastomosis was still considered as standard. However, a single-layer extramucosal intestine anastomosis has shown favorable results. This study created an anastomotic model to compare the anastomosis strength and leakage between double-layer full-thickness and single-layer extramucosal intestine anastomosis. Methods: This experimental study was performed in 20 randomized healthy male pigs, to be included either in Group A (Single-layer extramucosal intestine anastomosis) or Group B (Double-layer full-thickness intestine anastomosis). Enterotomy followed by an end-to-end anastomosis suture was performed in the jejunum. Fourteen days after the operation, any anastomosis leakage and its location was documented. The anastomosis strength was evaluated using manometry. Data were compared between groups using the Mann–Whitney U and Fischer Exact test, considering a significance level of P<0.05. Results: The overall mean intraluminal anastomotic bursting pressure was 4,257±1,185. Group A had a higher intraluminal anastomotic bursting pressure but was not statistically significant compared to group B (4.726±0.952 vs. 3.787±1.252 kilopascals, P=0.063). One leakage (5%, antimesenteric area) occurred in Group A and three leakages (15%, antimesenteric and mesenteric area) occurred in Group B. However, statistical analysis with Fischer exact showed no significant difference of leakage rate between those groups (P=0.291). Conclusions: The anastomosis strength and leakage did not differ significantly between the single-layer extramucosal intestine anastomosis group and the double-layer full-thickness anastomosis group. However, the location of leakage was most common in the antimesenteric area in the double-layer full-thickness anastomosis group.
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Baruah, Alfred, Dhirendra Nath Choudhury, and Kamal Krishna Patowary. "A comparison of extra-mucosal single layer interrupted repair vs conventional double layer repair of intestinal anastomosis: a hospital-based study." International Journal of Research in Medical Sciences 12, no. 12 (2024): 4653–57. https://doi.org/10.18203/2320-6012.ijrms20243722.
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Background: Intestinal anastomosis is a critical surgical technique used to resect and reconnect segments of the gastrointestinal tract. Traditional double-layered techniques using both absorbable and non-absorbable sutures have been widely used. However, single-layer anastomosis is gaining interest due to its simplicity, cost-effectiveness, and reduced operating time. This study aims to compare the outcomes between extra-mucosal single-layer interrupted repair and conventional double-layer repair. Methods: A prospective, randomized controlled study was conducted over six months with 42 patients undergoing intestinal resection and anastomosis. Patients were randomized into two groups: single-layer anastomosis (Group A) and double-layer anastomosis (Group B). Both groups were monitored for key outcomes such as anastomotic leak, return of bowel function, surgical site infection, and hospital stay. Results: The single-layer technique showed a significantly shorter operative time (23.8±2.5 minutes) compared to the double-layer technique (33.1±2.6 minutes). There were no statistically significant differences in anastomotic leak rates, re-interventions, or surgical site infections between the two groups. The cost of materials was lower for single-layer anastomosis. Conclusions: Single-layer anastomosis offers a time-efficient, cost-effective alternative to double-layer anastomosis with comparable clinical outcomes. The findings support the broader adoption of the single-layer technique, particularly in resource-limited settings.
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Shah, Tuhin, RK Agarwal, RK Gupta, CS Agrawal, and S. Khaniya. "Single-layer versus double-layer intestinal anastomosis: A comparative study." Health Renaissance 13, no. 2 (2017): 134–43. http://dx.doi.org/10.3126/hren.v13i2.17563.
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Background: Intestinal anastomosis is essential to maintain the continuity after resection. There has been constant controversy due to various repair options. Adequate apposition can be achieved by either single- or double-layer anastomosis which may affect the post-operative outcome.Objective: To compare the outcome of single-layer versus double-layer anastomosis of small and large intestine.Method: This prospective comparative study was conducted over a period of 16 months, and included 78 patients who underwent intestinal anastomosis (without diverting stoma) after fulfilling inclusion and exclusion criteria. They were randomized into double-layer and single-layer intestinal anastomosis groups by a computer generated series. Double layer anastomosis was constructed using inner continuous Polyglactin 3-0 and outer interrupted Silk 3-0, while single layer anastomosis was done with interrupted PDS 2-0.Result: The mean age was 39.79±17.78 years. A total of 59% were operated in emergency room while 41% in elective setting. Overall mean time for anastomosis was 31.81±6.03 (21-50) minutes. In double- and single-layer intestinal anastomosis mean time was 34.35±5.80 (26-50) and 29.13±5.08 (21-45) minutes respectively, which was statistically significant (p value < 0.05). Single-layer was completed 5 minutes earlier than double layer anastomosis in average. Clinical anastomotic leak was seen in six (7.7%) patients, three in each group. Eight (10.3%) patients had surgical site infection: 3 in double-layer and 5 in single-layer groups. One (1.3%) mortality was seen, from single-layer anastomosis group.Conclusion: Single-layer anastomosis can be constructed in significantly shorter time with similar complication rate when compared to doublelayer anastomosis.Health Renaissance 2015;13(2): 134-143
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Rahman, S., MA Khair, F. Khanam, et al. "Double layer versus Single layer Gastro-intestinal anastomosis in gastric cancer surgery in Mymensingh Medical College Hospital." Community Based Medical Journal 2, no. 2 (2013): 30–34. http://dx.doi.org/10.3329/cbmj.v2i2.16695.
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Introduction: In gastric cancer surgery, gastrojejunostomy is one of the most important procedures. Anastomosis between different parts of the stomach and the intestine is a basic technical component in all gastrointestinal procedure. Backgrounds and aims: This study evaluated complications of gastrojejunostomy in gastric cancer surgery with two methods: single-layer and double-layer anastomosis. Materials and methods: This study was carried out in the department of surgery in Mymensingh Medical College Hospital from January 1, 2009 to December 31, 2012. 100 patients with carcinoma stomach who needed gastrojejunostomy were included in this study. These patients with average age of 43.22 years were divided in two groups (50 in each group); single-layer and double-layer anastomosis. In single-layer anastomosis gastrojejunostomy was performed in interrupted method with absorbable suture (2/0 vicryl). Double-layer anastomosis was carried out with continuous suture (2/0 silk, 2/0 catgut). Possible post-operative complications like anastomotic leakage, pelvic abscess, abdominal sepsis, anastomotic stenosis and wound infection were evaluated. Results: In the single-layer group, 4 patients (8%) developed anastomotic leakage, wound infection and only 2 patients (4%) developed abdominal sepsis, pelvic abscess and anastomotic bleeding. No patient developed anastomotic stricture. In double-layer group, 2 (4%) patients developed anastomotic leakage, only 1 (2%) patient had pelvic abscess, abdominal sepsis and anastomotic bleeding but wound infection in 2 (4%) patients. Conclusion: Gastrojejunostomy with single-layer hand-sewn suture technique is safe without serious complications in comparison to double-layer suture technique. More-over operation time is less and cost is less in single-layer method.DOI: http://dx.doi.org/10.3329/cbmj.v2i2.16695 Community Based Medical Journal 2013 July: Vol.02 No 02: 30-34
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Sayeed, Dr Abu, Md Aminul Islam, Dr Md Abdul Kuddus Mondal, Dr Monishankor Roy, Dr Sarder Belal Hossain, and Dr Md Belal Uddin Akanda. "Single Versus Double Layer Intestinal Anastomosis: A Comparison of Features and Treatment Outcomes." SAS Journal of Surgery 11, no. 02 (2025): 123–28. https://doi.org/10.36347/sasjs.2025.v11i02.003.
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Background: Intestinal anastomosis is a critical surgical procedure for restoring gastrointestinal continuity after resection. The choice between single-layer and double-layer anastomosis techniques remains a subject of debate, with implications for operative time, complication rates, and long-term outcomes. This study aimed to compare the features and treatment outcomes of single-layer versus double-layer intestinal anastomosis. Methods: This comparative study, conducted at Shaheed Ziaur Rahman Medical College Hospital in 2011, included 92 patients undergoing intestinal anastomosis. Group I (45 patients) had single-layer anastomosis, while Group II (47 patients) underwent double-layer procedures. Data were analyzed using SPSS 23.0, with participants selected via consecutive sampling. Results: Postoperative bowel function returned faster in the single-layer group (76.27 hours) compared to the double-layer group (85.91 hours). First oral intake began earlier in the single-layer group. Wound infection rates were 6.66% in Group I and 12.58% in Group II. Anastomotic leakage occurred in 4.44% of Group I and 10.56% of Group II patients. Mortality was 0% in Group I and 2.12% in Group II. Hospital stays averaged 9.42 days for Group I and 10.8 days for Group II. Conclusion: The single-layer anastomosis method offers notable advantages over the double-layer conventional technique. Patients undergoing single-layer anastomosis experience a quicker postoperative return of bowel function and an earlier initiation of oral feeding. Additionally, this approach is associated with a lower incidence of anastomotic failure and septic complications. Consequently, single-layer anastomosis is both a safe and cost-effective option for surgical treatment.
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Nemma, Shobhit K., Sarbjeet Singh, Amritpal Singh Rana, Rohit Kapoor, and Puneet Bansal. "Small intestine anastomosis by full thickness, single layer and interrupted suture technique: results of a comparative study." International Surgery Journal 6, no. 3 (2019): 675. http://dx.doi.org/10.18203/2349-2902.isj20190813.
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Background: Since the dawn of surgery intestinal anastomosis has remained a controversial topic in respect to suture material, anastomotic technique, distance between stitches and borders. Technique of anastomosis is an important determinant in process of anastomosis healing. Despite a large amount of work done on anastomosis techniques, a clear superiority of one technique over another has not been established.Methods: Patients of ileostomy reporting to surgery department for stoma closure were used for study. 80 patients of ileostomy reporting for stoma closure were used as material for the study and randomized in two groups. In single layer group, using 3-0 silk suture, we performed small intestine anastomosis applying single layer of interrupted sutures taking full thickness bite. In double layer group, anastomosis was performed anastomosis by applying first layer of full thickness sutures and second layer of seromuscular sutures. The results were compared in terms of operative time, post operative complications, mortality, hospital stay and cost of the suture material.Results: The mean age of the patients was 33.55 yr in group A (single layer) and 35.85 yr in group B (double layer). Total 7 patients developed anastomotic leak. 5 (12.5%) patients were with double layer anastomosis and 2 (5%) patients were in single layer group. The difference in anastomosis leak in two groups was statistically insignificant (p = 0.232). The mean duration of whole procedure in group A (single layer) was 52.5min and 71.5min in group B (double layer). The difference in mean duration of the procedure was found to statistically significant (P = 0.00).Conclusions: We concluded the single layer technique to be a safe, efficient and more cost effective as compared to double layer technique.
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Adhikari, Bimarsh. "Single Layer versus Double Layer Technique for Intestinal Anastomosis: A Comparative Study." Journal of Nepalgunj Medical College 19, no. 2 (2021): 7–10. http://dx.doi.org/10.3126/jngmc.v19i2.42792.
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Introduction: Intestinal anastomosis is a surgical procedure executed to ascertain communication between two segments of the intestine, after the removal of pathology affecting the bowel. It depends on factors like anastomosis site, bowel capability and the type of the pathogenesis. Aims: To compare single versus double layer method in terms of time taken for anastomosis, hospital stay, post-operative leak and cost effectiveness. Methods: This is a comparative hospital based study carried out at the department of surgery Nepalgunj Medical College from September 2017 to August 2020. Patients requiring emergency laparotomy with resection and anastomosis of small bowel were included. Patients requiring colonic anastomosis, diversion stoma and multiple anastomoses were excluded. Patients were divided in to two groups- single layer and double layer group. Each group was compared for outcome measures like time taken to construct the anastomosis, hospital stay, post-operative leak and cost of surgery. Results: The total number of patients was 50. The mean age was 45.57±17.42 years for single layer and 48.67±18.16 years for double layer group. Time taken for intestinal anostomosis in single and double layer were 18.28±5.08 and 25.27±6.18 respectively which was statistically significant (p - <0.012). Hospital stay was 10.9±1.43 in single layer and 11.2±1.87 which was statistically not significant (p - >0.342). Similarly, the anastomosis leak was seen in 2 patients in single layer and 3 in double layer. Which was statistically not significant (p - >0.318). While comparing the cost effectiveness single layer technique was cost effective. Conclusion: The single layer anastomosis is a preferable, safe and economic technique in comparison to the conventional double layered anastomosis.
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Khattak, Bilal, Faiz Ur Rahman, Irfan Ul-Islam Nasir, Muhammad Iftikhar, Imtiaz Ahmad Khattak, and Zia Ur Rehman. "Single Layer Extra-Mucosal Interrupted Anastomoses; Revalidated." Journal of Gandhara Medical and Dental Science 2, no. 1 (2015): 22–26. http://dx.doi.org/10.37762/jgmds.2-1.59.
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Objective:To evaluate the safety regarding anastomotic failure of single layer interrupted extra mucosal intestinal anastomosis in comparison with double layer intestinal anastomosisMethodology:This prospective comparative study was conducted in surgical A unit of Lady reading Hospital Peshawar from 1st June 2007 to 1st February 2008 (8 months).Patients were divided into two groups, each comprising 60 patients. First 60 consecutive patients were included in Group A, for single layer extra mucosal anastomosis while Group B included last 60 consecutive patients for double layer inverting anastomosis (continuous inner and interrupted outer Lambert sutures). All the cases were admitted through OPD and emergency. The safety of two techniques of anastomosis was analyzed by comparing the outcome in terms of complications.Results:In this study, anastomosis leakage occurred only in 4 (3.33%) patients, one (1.67%) in group A and three (5%) in group B with a P-Value 0.138. Mean age of patient in group A was 36.15 years (+/- 6.0 years) and in group B was 33.25 years (+/- 5.5 years).Conclusion:Single layer extra-mucosal anastomosis has least anastomotic leakage and other complication like wound infection, septicemia, and collection and burst abdomen than in patients with double layer investing anastomosis.
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Owaid, Layth Saleh, Imad Wajeeh Al-Shahwani, Zuhair B. Kamal, Laith Naif Hindosh, Abbas Farman Abdulrahman, and Haider Salim Mihson. "Single Layer Extra-Mucosal Versus Double Layer Intestinal Anastomosis for Colostomy Closure: A Prospective Comparative Study." AL-Kindy College Medical Journal 17, no. 2 (2021): 95–99. http://dx.doi.org/10.47723/kcmj.v17i2.274.
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Background: The main objective was to compare the outcome of single layer interrupted extra-mucosal sutures with that of double layer suturing in the closure of colostomies.
 Subjects and Methods: Sixty-seven patients with closure colostomy were assigned in a prospective randomized fashion into either single layer extra-mucosal anastomosis (Group A) or double layer anastomosis (Group B). Primary outcome measures included mean time taken for anastomosis, immediate postoperative complications, and mean duration of hospital stay. Secondary outcome measures assessed the postoperative return of bowel function, and the overall mean cost. Chi-square test and student t-test did the statistical analysis..
 Results: Thirty-two patients were allocated to group A and 35 patients to group B. The mean time taken for anastomosis was significantly shorter in group A (23.25 ± 1.20 min in group A vs. 36.71 ± 1.93 min in group B; P<0.001). A significant shorter duration of hospital stay was seen in group A (7.00 ± 1.778 days in group A vs. 9.74 ± 1.990 days in group B; P<0.001). The detection of bowel sound was substantially quicker in group A as compared to group B (4.56 ± 0.50 days in group A vs. 6.46±0.50 days in group B; P<0.001). There was no significant discrepancy between the two groups regarding anastomotic leak rates (P= 0.543). The mean cost of double layer intestinal anastomosis method was significantly higher than that of single layer anastomosis (P<0.001).
 Conclusions: The use of single layer extra-mucosal anastomosis of the intestine has the advantage of taking less time, less morbidity and cost-effective to perform with the same rate of anastomotic leak in the closure of colostomy.
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Dhamnaskar, Suchin S., Anil Baid, Nishant Gobbur, and Pratik Patil. "An observational comparative study of single layer continuous extramucosal anastomosis versus conventional double layer intestinal anastomosis." International Surgery Journal 7, no. 12 (2020): 4101. http://dx.doi.org/10.18203/2349-2902.isj20205363.
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Background: Conventional double layered technique of intestinal anastomosis are widely in practise. Some surgeons also practice single layer technique either continuous or interrupted. This was a prospective observational study to compare safety, efiicacy and feasibility of single versus double layered continuous techniques.Methods: Patients undergoing intestinal anastomosis with either of these two techniques were observed prospectively for various outcome parameters like length of suture material used, time taken for anastomosis, and that for entire surgery, postoperative complications, return of bowel activity etc. Data such obtained was analysed for statistical significance by applying chi-square test and unpaired ‘t’ test.Results: Length of suture used for single layer (mean of 15.06 cm) was statistically significantly lesser than that for double layer (mean 19.90 cm) (p.0.001). Time taken for anastomosis and overall surgical time too was significantly less for single layer group (p.0.001 and 0.022 respectively). Complications including anastomotic dehiscence were not significantly different between two groups. Postoperative recovery of bowel function was earlier in single layer group with marginal statistical significance (p=0.048).Conclusions: Thus in our study, single layer continuous method of intestinal anastomosis resulted in significant reduction in time, suture material length and cost; without any difference in complications and it marginally hastens the postoperative recovery of bowel function. So single layer continuous method can be recommended for intestinal anastomosis.
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AHMAD KHAN, RANA ASRAR, Mohammad Dilawaiz, FAKHAR HAMEED, Ch Mohammad Akram, and BASHIR AHMED. "INTESTINAL ANASTOMOSIS." Professional Medical Journal 17, no. 02 (2010): 232–34. http://dx.doi.org/10.29309/tpmj/2010.17.02.2350.
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Objective: To evaluate the safety and cost effectiveness of single layer interrupted intestinal anastomosis in comparison with the double layer conventional method of intestinal anastomosis. Study Design : Prospective comparative study. Period & Setting: Surgical unit 4 DHQ hospital Faisalabad operated by single team during 12 months starting from Feb. 2007 to Jan. 2008. Materials and Methods: The cases were assigned to the two techniques, each being applied on alternate patient, single layer extra mucosal interrupted anastomosis anddouble layer anastomosis. In group 1 we used black silk 3/0 and in double layer we used vicryl 3/0 for inner continuous layer and black silk 3/0 for outer continuous layer. Comparison between two techniques was done on the bases of procedure time, cost effectiveness, morbidity in terms of rate of leakage/. Results: Average time for the construction of the single layer anastomosis was 20 minutes and in double layer was 35 minutes, the difference in average time is statistically significant (p<.001) while average duration of stay was 168 hrs and 216 hrs in group 1 and 2 respectively (p<.001). Leakage rate was double (12%) in group 2 while 6% in group 1. Moreover structure material consumption was more in two layered technique and longer stay added to that lead to more hospital expenses on two layered technique. Conclusion: Anastomosis usinga single layer interrupted extra mucosal technique was faster to perform, cost effective, less likely to leak and as strong as a 2-layer anastomosis.
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Modi, Jenishkumar Vijaykumar, and Namrata Puwar. "A comparative study of single layer versus double layer small bowel anastomosis." International Surgery Journal 10, no. 5 (2023): 888–91. http://dx.doi.org/10.18203/2349-2902.isj20231386.
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Background: There are various gastrointestinal surgeries in which we require small bowel anastomosis. Bowel anastomosis is quite common in different bowel pathology. Bowel anastomosis can be done by hand sewn or y stapler. In hand sewn anastomosis, we can do single layer or double layer anastomosis. Method: The study was carried out in 50 patients between August 2019 to March 2020. In this study, we have included all the patients who require small bowel end to end anastomosis in either elective surgeries or emergency surgeries. Patients who require proximal stoma formation and other than small bowel anastomosis are excluded. In present study, patients were randomly allocated in two groups: group A (n=25) includes single layer(interrupted) hand sewn bowel anastomosis and group B two layer (Connell and seromuscular) handsewn bowel anastomosis. Author have compared two groups in terms of intraoperative time and postoperative leak. Results: This shows that there is significantly reduce in intraoperative time in group A patient while there is no significant difference in postoperative complication or postoperative leak between two groups. Conclusions: There is no significant difference in single layer and double layer technique of bowel anastomosis.
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ASKARPOUR, Shahnam, Mehran PEYVASTEH, Hazhir JAVAHERIZADEH, and Nasim ASKARI. "EVALUATION OF RISK FACTORS AFFECTING ANASTOMOTIC LEAKAGE AFTER REPAIR OF ESOPHAGEAL ATRESIA." ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) 28, no. 3 (2015): 161–62. http://dx.doi.org/10.1590/s0102-67202015000300003.
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Background: Anastomotic leak are reported among neonates who underwent esophageal atresia. Aim: To find risk factors of anastomotic leakage in patients underwent esophageal repair. Methods: All cases with esophageal atresia were included. In this case control study, patients were classified in two groups according to presence or absence of anastomotic leaks. Duration of study was 10 years. Results: Sixty-one cases were included. Mean±SD age at time of surgery in patients with leakage and without leakage was 9.50±7.25 and 8.83±6.93 respectively (p=.670). Blood transfusion and two layer anastomosis had significant correlation with anastomotic leakage. Conclusion: Blood transfusion and double layer anastomosis are associated with higher rate of anastomotic leakage.
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Dr., Muhammad Tanveer Sajid Dr. Rana Shakeel Ahmed Dr. Nazish Syed. "COMPARISON OF EFFICACY OF INTESTINAL ANASTOMOSIS SUTURED IN SINGLE LAYER VERSUS TWO LAYER." INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES 06, no. 01 (2019): 274–77. https://doi.org/10.5281/zenodo.2530234.
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<strong><em>Objective:</em></strong><em> To evaluate the safety of an extra mucosal intestinal anastomosis in a single layer compared to conventional double-layer intestinal anastomosis.</em> <strong><em>Study design:</em></strong><em> A case control study.</em> <strong><em>Configuration and Duration:</em></strong><em> In the Surgical Unit II of Services Hospital Lahore for six months duration from January 2018 to June 2018.</em> <strong><em>Methodology:</em></strong><em> All patients needs intestinal anastomosis were selected. The two groups of patients were made. In A group, an extra-mucosal interrupted anastomosis of a single layer was performed with vicryl 2/0, while in group B, with vicryl 2/0 a conventional double-layered anastomosis was done. The results of the two techniques were compared in terms of morbidity, mortality and cost-effectiveness.</em> <strong><em>Results:</em></strong><em> Ninety patients were included in the study (42 in group A and 48 in group B). The mean age of the group A was 37.5 and the B group was 40.2 years, respectively. Entero-colostomy, colo-colostomy and Entero-enterostomy were done in 10(23.8%), 2(4.7%) and 30(71.4%) patients in-group A and 10(20.8%), 3(6.3%) and 35(72.9%) patients in group B respectively. Two patients (4.7%) in Group A and four patients (8.3%) in group B developed anastomotic leaks with a general mortality rate of 0% and 4.1% in group B.</em> <strong><em>Conclusion:</em></strong><em> Single </em><em>layer interrupted extra mucosal intestinal </em><em>can be formed in less time with a less complication compared to the two-layer technique. Surgical training program can be entered safely in this regard.</em> <strong>Key Words:</strong><em> Anastomosis, Fugue, monolayer interruption, morbidity and mortality.</em>
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Habash, Mohammed M., Yahya K. Hammoudi, and Tharwat I. Sulaiman. "Single-layer seromuscular Continuous Versus Two-Layers Intestinal Anastomosis Of Small bowel in Baghdad Teaching Hospital (A prospective Study)." Journal of the Faculty of Medicine Baghdad 55, no. 4 (2014): 308–12. http://dx.doi.org/10.32007/jfacmedbagdad.554569.
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Background: Anastomosis may be done with the help of stapling devices, by using double layered suturing technique or by a single layer technique.Patients and methods: A prospective study conducted in Baghdad Teaching Hospital, Iraq. A total of sixty- four patients were included in this study. They were divided into two groups; group A, 28 patients, single layer seromuscular continuous anastomosis was done and group B, 36 patients underwent conventional double layered anastomosis.Objective: The aim of the study is to prove that a single layer continuous technique can be constructed in a significantly less time with similar rate of complications compared with two layers technique.
 Results: There were, 15 male (53.6%) and 13 (46.4%) female within group A and 20 (55.6%) male and 16 (44.4%) female within the group B. There was no significant difference in gender distribution or mean age between or within groups. Bullet and sharp nail injuries to the abdomen were the most common causative agents followed by malignant disease of GIT. Wound infection was the most frequent complication in both groups as fourteen patient out of 64 (21.9%) developed wound infection; 8 of them were among group B. There was no significant difference in the incidence of anastomotic leakage; in group A was 3.6%, while in group B was 4.7%. The average time for the construction of the single layer anastomosis was 20 min and in double layer it was 35 min. The difference in average time is statistically significant
 Conclusion: The single-layer continuous anastomosis requires less time to construct and has a similar risk of leakage compared with the two-layer technique. It also costs less than any other method and can be safely introduced into a surgical training program.
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Ivanov, Stanislav Dmitrievich, Grigoriу Vladimirovich Slizovskiу, Yana Vladimirovna Shikunova, et al. "Experimental Simulation of Compression Anastomosis in Double-Barreled Enterostomy Using a Titanium Nickelide Memory Shape Device." Journal of Experimental and Clinical Surgery 15, no. 1 (2022): 46–57. http://dx.doi.org/10.18499/2070-478x-2022-15-1-46-57.
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Introduction. Enterostomy remains a relevant option of staged treatment of small intestine diseases in children. T-anastomosis with stoma (Bishop-Koop) and double-barreled enterostomy with compression anastomosis (Mikulicz) are among the most widely accepted ones. Disadvantages of compression anastomosis can be eliminated by using a NiTi-clip with shape memory. The aim of the study was to perform an experimental study to detect effectiveness and advantages of NiTi-clip application in formation of a compression anastomosis in a double-barreled enterostomy compared with manual T-anastomosis. Methods. The study included 24 rabbits of the "Serebristyi" breed, aged 2.5-3 months, weighed 2790-3100 g; they were divided into two equal groups. Autopsy was performed in 10, 14, 21 days with pneumopression and histological examination. Differences were considered statistically significant at p-value 0.05. Results. The duration of the Mikulicz operation (group A) was significantly shorter than that of Bishop-Koop`s (group B) (p = 0.000). Significant differences in weight were found in 14. 21 days, with a predominance in group A (p = 0.029). Complications included wound suppuration, eventration, peritonitis, evagination, dermatitis, and anastomotic leakage. In 10 days, compression anastomosis had a lower anastamotic pressure, but in 21 days, it was more stabile than in manual anastomosis (p = 0.019). In 14 days, inflammatory changes in the mucosa with fibrosis in the muscle layers and lesions were detected in the area of manual anastomosis, they were accompanied by inflammation around sutures. In 21 days, fibrotic changes spread in all layers. Proliferation prevailed over inflammation in the area of the compression anastomosis. Conclusions. Double-barreled stoma formation with NiTi-clip application took less time than T-anastomosis. Animals with a double-barreled stoma and compression anastomosis had a larger weight gain. Compression anastomosis with NiTi-clip in the stoma was stabile than manual anastomosis. With compression anastomosis, layer-by-layer regeneration from serous to mucous membrane occurs, healing occurred faster, with a predominance of proliferation processes, the risk of stenosis decreased. The use of NiTi-clip in the surgical treatment of children with double-barreled enterostomy can be recommended for practical use.
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Baset, Md Abdul, Bhupal Chandra Barman, Samiha Tasnim Munmun, and Md Tanvir Ahmad. "Single Layer Interrupted Gastroenterostomy, A Superior Technique Over Double Layer Continuous Gastroenterostomy." Scholars Journal of Applied Medical Sciences 13, no. 05 (2025): 1132–36. https://doi.org/10.36347/sjams.2025.v13i05.020.
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Background: Gastroenterostomy is a widely performed surgical procedure for treating gastric outlet obstruction and other upper gastrointestinal pathologies. Traditionally, the double-layer continuous technique has been the standard due to its perceived durability. However, it is associated with increased operative time, tissue handling, and risk of postoperative complications such as anastomotic leakage. In recent years, the single-layer interrupted technique has emerged as a potentially superior method, offering advantages in terms of operative simplicity, reduced tissue trauma, and faster recovery. Objective: This study aimed to compare the clinical outcomes of single-layer interrupted gastroenterostomy with the conventional double-layer continuous method, focusing on operative time, postoperative complications, recovery period, and overall effectiveness. Method: A prospective randomized study was conducted between January 2023 and December 2024 at the Department of Surgery, Rangpur Medical College Hospital, Bangladesh. A total of 100 patients requiring gastroenterostomy were randomly assigned into two groups: Group A (n=50) underwent single-layer interrupted anastomosis, while Group B (n=50) underwent double-layer continuous anastomosis. Key outcomes measured included operative convenience, operative time, intraoperative blood loss, postoperative complications (e.g., leak, infection), time to return of bowel function, and hospital stay duration. Result: Group A demonstrated significantly shorter operative times (average 90 minutes vs. 120 minutes), less blood loss, and earlier return to oral feeding. Postoperative complication rates, including wound infection and anastomotic leak, were lower in the single-layer group. Mean hospital stay was also shorter in Group A (5 days vs. 7 days), indicating a faster recovery profile. Conclusion: The single-layer interrupted gastroenterostomy technique offers a simpler, easier, safer, and more efficient alternative to the tra
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Ma, Pengfei, Yuzhou Zhao, and Xijie Zhang. "Safety of double and a half-layered esophagojejunal anastomosis in total gastrectomy with gastric cancer." Journal of Clinical Oncology 38, no. 15_suppl (2020): e16563-e16563. http://dx.doi.org/10.1200/jco.2020.38.15_suppl.e16563.
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e16563 Background: Esophageal jejunal anastomotic fistula is still one of the serious postoperative complications of gastric cancer, the incidence was 1% ~ 16.5%. The aim of this study was to evaluate the safety of double and a half layered esophagojejunal anastomosis in total gastrectomy. Methods: The new method was called double and a half layered esophagojejunal anastomosis: esophagojejunal anastomosis was performed with a tubular stapler, then the anastomosis was reinforced by absorbable suture (Full-layer continuous suture, slurry muscularis embedding). The new method was used in observation group (n = 295). In the control group(n = 469),the esophagojejunal anastomosis was performed with a tubular stapler, then reinforced by intermittent suture with absorbable sutures. Data analysis including operating time, blood loss, anastomosis time, types and cases of postoperative complications, and postoperative hospitalization time. Results: The data of 764 patients who performed radical gastrectomy between May 2015 and May 2019 were analyzed retrospectively. 1.Surgery situations: The operating time (140.66±26.96 min vs 139.61±22.75min, t= 0.581, P> 0.05) blood loss (200.61±111.03ml vs214.45±114.09ml, t= -1.481, P> 0.05), anastomosis time (20.44±4.31min vs19.92±4.58min, t= 1.573, P> 0.05), postoperative hospitalization time (15.35±6.46 d vs15.89±5.58d, t= -1.229, P> 0.05) .2. Postoperative situations: the rates of anastomotic complications in observation group was 1.69% (5/295) and 4.69% (22/469) in control group, with a statistically significant difference between two groups( χ2 = 4.768, P< 0.05). The rates of anastomotic leakage in observation group was lower than that in the control group 1.02% (3/295) vs 3.41% (16/469) ( χ2 = 4.282, P< 0.05) . The severity of anastomotic leakage, anastomotic stenosis, anastomotic bleeding were no statistically significant differences between two groups( χ 2= 2.030,1.261,0.075, P> 0.05). Total postoperative complications: 101 cases (34.24%) in the observation group, 14 cases (4.75%) with severe complications, and 1 case death. 151 cases (32.2%) in the control group, 34 cases (7.25%) with serious complications, and 2 cases death ( χ2 = 0.838, Z = -1.465, P > 0.05). Conclusions: Double and a half layered esophagojejunal anastomosis is safe and feasible in total gastrectomy, which can reduce the incidence of anastomosis complications.
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Nema, Archana A. "Comparison Study of Single Layer versus Double Layer Anastomosis in Bowel Surgery in Western India." New Indian Journal of Surgery 9, no. 3 (2018): 286–90. http://dx.doi.org/10.21088/nijs.0976.4747.9318.7.
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Mittal, Sushil, Harnam Singh, Gurpreet Singh, Anand Munghate, Anjna Garg, and Manish Yadav. "A comparative study between single layer versus double layer closure in ileostomy reversal." Asian Journal of Medical Sciences 6, no. 2 (2014): 43–46. http://dx.doi.org/10.3126/ajms.v6i2.10080.
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Background: Ileal perforation peritonitis is a common surgical emergency in the Indian subcontinent and in tropical countries. Formation of an intestinal stoma is frequently a component of surgical intervention for diseases of the small bowel. The technique for stoma reversal has remained controversial is the use of either one or two layers of sutures for anastomosis.Methods: Sixty patients with ileostomy were taken for study .These patients divided in two groups A and B, 30 each. These patients were taken up for ileostomy closure in single layer (group A) (n-30) &double layer (group B) (n-30). Results: 60 Patients of ileostomy were studied, divided equally in 2 groups, A decreased intra operative time was seen in Group A when compared with Group B with no any significant comparative complication in these groups. Conclusion: Two-layer anastomosis for ileostomy closure offers no definite advantage over single layer anastomosis in terms of postoperative leak and other complications. Single layer ileostomy closure technique is safe, easy to perform and simply to taught. Considering duration of the anastomosis procedure and medical expenses single-layer intestinal anastomosis may prove the choice of procedure for most of the surgeons. DOI: http://dx.doi.org/10.3126/ajms.v6i2.10080Asian Journal of Medical Sciences Vol.6(2) 2015 44-47
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Sharma, Shweta, Sudhansu Shekhar Mohanty, and Sushanta Kumar Das. "Intestinal Anastomosis Single Layer versus Double Layer - A Prospective Study." Journal of Evidence Based Medicine and Healthcare 7, no. 13 (2020): 671–74. http://dx.doi.org/10.18410/jebmh/2020/146.
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Dr., Saira Mahmood Dr.Sana Ali Dr. Sidra Atta. "COMPARISON OF SINGLE WITH DOUBLE LAYER INTESTINAL ANASTOMOSIS." INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES 05, no. 12 (2018): 15614–20. https://doi.org/10.5281/zenodo.2028454.
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<strong><em>Objective: </em></strong><em>In contrast to administration conclusion of single coating intermittent extra mucosal intestinal anatomists’ with twice were coating conservative technique of intestinal anatomists. </em> <strong><em>Materials and Method: </em></strong><em>Our proportional learning research was completed at Surgical Department of Mayo Hospital, Lahore from January to November 2017. Mature patient experience compulsory and urgent situation minute or huge gut anatomists are integrated. Esophageal, gastric or billiard anatomists are expelled. 60 patients were alienated in 2 set of thirty patient each. In set-A single coating intermittent extra-mucosal anatomists was complete or in set-B twice coating anatomists. Major conclusion procedures were to contrast extent of process, post-operative escaped, or post-operative period of hospital lived.</em> <strong><em>Results: </em></strong><em>Anastigmatic escape happen in 2 (6.5%) patient of set A or in single (3.3%) patients of set B (p=0.55). denote of time taken for anatomists was 18.30 minute in set A or 25.86 minute in set B (p=0.001). denote of period of post functioning hospital reside was six days in set A and 5.86 days in set B (p=0.8).</em> <strong><em>Conclusions:</em></strong><em> Single coating extra mucosal intestinal anatomists are similarly secure and can be complete in shorter instance than the twice coating intestinal anatomists. </em> <strong>Keyword:</strong> <em>Anatomizes, Extra mucosal and Anastigmatic Escape.</em>
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Malik, Ajaz A., Munir A. Wani, Shahbaz Bashir, et al. "Single-layer vs Double-layer Intestinal Anastomosis: A Prospective Comparative Study." Euroasian journal of hepato-gastroenterology 15, no. 1 (2025): 18–23. https://doi.org/10.5005/jp-journals-10018-1464.
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Dyegura, Osmund J. "Prevalence and Factors Associated with Anastomotic Leakage Among Patients Undergoing Bowel Resection and Anastomosis." International Journal of Health, Medicine and Nursing Practice 6, no. 1 (2024): 1–14. http://dx.doi.org/10.47941/ijhmnp.1604.
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Purpose: This study aimed at giving evidence on prevalence and factors associated with anastomotic leakage among patients undergoing bowel resection and anastomosis at Bugando Medical Centre (BMC) and Sekou Toure Regional Referral Hospital (SRRH).
 Methodology: A descriptive cross-sectional analytical study was used involving patients undergoing bowel resection and anastomosis at Bugando Medical Centre and Sekotoure regional referral hospital over a four-month period from March 2017 to June 2017 inclusive.
 Findings: Eight out of 144 patients (5.6%) developed anastomotic leakage. The common indication for surgery was sigmoid volvulus, the common performed anastomosis was ileo-ileo end to end, and double layer continuous anastomotic suture was the common method of anastomosis Anemia (0.012), presence of premorbid illnesses (p=0.003), American association for anesthesia (ASA) greater than II (p=0.001), intraoperative contamination/sepsis (p< 0.001), low ranked operator (p=0.046), prolonged duration of operation (p=0.001), and delayed passage of stool and flatus (p=0.001) were found to be variables associated with anastomotic leakage among study participants. Anastomotic leakage in our setting occurs in approximately 5.6% of patients operated. Several factors such as high American society for Anesthesiologist above III, premorbid condition such as uncontrolled Diabetes Mellitus, intraoperative contamination/sepsis, low ranked operator, prolonged duration of operation above 3 hours and prolonged ileus were among factors that the present study found to be associated with high risk of anastomotic leakage.
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Hanson, R. Reid, Alan J. Nixon, Maron Calderwood-Mays, and R. Gronwall. "Evaluation of three techniques for end-to-end anastomosis of the small colon in horses." American Journal of Veterinary Research 49, no. 9 (1988): 1613–20. https://doi.org/10.2460/ajvr.1988.49.09.1613.
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SUMMARY In an attempt to determine the best method for surgical removal of devitalized small colon lesions, 12 horses underwent a double small colon resection and end-to-end anastomosis. In 4 horses (study 1), an appositional single-layer (app-1) suture pattern was compared with an inverting 2-layer (inv-2) suture pattern. In 8 horses (study 2), an appositional 2-layer (app-2) suture pattern was compared with the inv-2 suture technique. Polydioxanone suture (size 1-0), was used. Horses were evaluated at necropsy 3, 10, 14, 28, or 56 days after surgery. Postoperative complications (peritonitis, impaction, or excessive adhesions) were encountered in 100, 42, and 13% of the app-1, inv-2, and app-2 anastomoses, respectively. Postmortem evaluation of the small colon revealed dehiscence of the anastomotic site, diffuse peritonitis, and adhesion formation in 3 of the 4 horses in which the resection line was closed with the app-1 pattern. With the inv-2 and app-2 techniques, more intestinal inversion was present in the nontaenial than in the taenial portion of the small colon. More postoperative impactions were found with the inv-2 (n = 5) anastomoses than with the app-2 (n = 1) technique; this appeared to be the result of excessive tissue inversion. There was no difference in lumen diameter between the inv-2 and the app-2 techniques (P ≥ 0.05). However, horses with unresponsive impactions at the inv-2 site had a smaller luminal diameter compared with the inv-2 anastomoses that did not impact or that impacted and resolved with therapy (P ≤ 0.001). Difference in adhesion formation between the inv-2 and the app-2 techniques was minimal. Bursting pressure studies (7 app-2, 7 inv-2, and 14 control) were performed in study 2. All segments consistently burst away from the anastomotic site along the mesenteric or antimesenteric taenial band. Differences in bursting pressure (P ≥ 0.05) were not evident between the 2 groups. Histologic evaluation revealed the app-1 pattern had no intestinal inversion. However, a wide full-thickness deposition of dense fibrous connective tissue in the submucosal and muscular layer was evident. The inv-2 and the app-2 patterns had pronounced inversion of the anastomotic layers along the nontaenial portion of the anastomoses, with minimal deposition of fibrous connective tissue between the anastomotic layers. The inversion formed a protruding ridge into the lumen that was more pronounced in the inv-2 than in the app-2 anastomoses. At 28 days, the inverted tissues were held firmly together by maturing fibrous connective tissue that was covered by a mucosal layer. The inverted tissues were as pronounced at 56 days as they were at 3 days. In light of these findings, we concluded that an app-2 pattern was the preferred surgical technique.
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Nayak, Ashok Kumar, Malaya Krishna Nayak, Dharbind Kumar Jha, Chinmaya Kar, and Debashree Maharana. "Comparison between extra mucosal continuous prolene repair versus interrupted through and through silk repair in colonic anastomosis." International Surgery Journal 6, no. 7 (2019): 2480. http://dx.doi.org/10.18203/2349-2902.isj20192978.
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Background: The traditional double layered colonic anastomosis incorporates large amount of ischemic tissue in the suture line causing luminal narrowing and fistula formations. Single layered anastomosis may be done through continuous extramucosal suturing or by interrupted through and through technique using nonabsorbable materials. The single layer of suture has shown to be safe and causes fewer complications.Methods: The study was conducted in the Department of surgery, VIMSAR, Burla during the period from October 2016 to September 2018. All the patients of colonic anastomosis were included in the study. One group consists of extra mucosal continuous prolene repair and other interrupted though and through silk repair. Both groups were followed up and were compared taking different variables.Results: 146 cases of colonic anastomosis were performed, 110 with interrupted through and through silk repair (75.34%) and 36 with continuous extra mucosal prolene repair (24.66%).The mean time taken for silk repair was more (25.67 min) than prolene (15.5 min). The patients of prolene repair had shorter duration (9 days) of hospital stay than silk (12.4 days). The postoperative ileus was more in silk (16.36%) than prolene (5.56%). Anastomotic leak in prolene is less (2.78%) in comparison to silk (8.18%). The bowel movement appeared earlier with prolene (4.2 days) is less than ssilk (5.3 days).Conclusions: The present study shows single layer monofilament thin diameter prolene for different end to end colonic anastomosis has better prognostic panorama in relation to morbidity and mortality, and had an edge over conventional single or bilayere anastomosis.
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Guadagni, Simone, Matteo Palmeri, Matteo Bianchini, et al. "Ileo-colic intra-corporeal anastomosis during robotic right colectomy: a systematic literature review and meta-analysis of different techniques." International Journal of Colorectal Disease 36, no. 6 (2021): 1097–110. http://dx.doi.org/10.1007/s00384-021-03850-9.
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Abstract Purpose Robotic assistance could increase the rate of ileo-colic intra-corporeal anastomosis (ICA) during robotic right colectomy (RRC). However, although robotic ICA can be accomplished with several different technical variants, it is not clear whether some of these technical details should be preferred. An evaluation of the possible advantage of one respect to another would be useful. Methods We conducted a systematic review of literature on technical details of robotic ileo-colic ICA, from which we performed a meta-analysis of clinical outcomes. The extracted data allowed a comparative analysis regarding the outcome of overall complication (OC), bleeding rate (BR) and leakage rate (LR), between (1) mechanical anastomosis with robotic stapler, versus laparoscopic stapler, versus totally hand-sewn anastomosis and (2) closure of enterocolotomy with manual double layer, versus single layer, versus stapled. Results A total of 30 studies including 2066 patients were selected. Globally, the side-to-side, isoperistaltic anastomosis, realized with laparoscopic staplers, and double-layer closure for enterocolotomy, is the most common technique used. According to the meta-analysis, the use of robotic stapler was significantly associated with a reduction of the BR with respect to mechanical anastomosis with laparoscopic stapler or totally hand-sewn anastomosis. None of the other technical aspects significantly influenced the outcomes. Conclusions ICA fashioning during RRC can be accomplished with several technical variants without evidence of a clear superiority of anyone of these techniques. Although the use of robotic staplers could be associated with some benefits, further studies are necessary to draw conclusions.
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Caronna, Roberto, Nadia Peparini, Gabriele Cosimo Russillo, Adolfo Antonio Rogano, Giuseppe Dinatale, and Piero Chirletti. "Pancreaticojejuno Anastomosis after Pancreaticoduodenectomy: Brief Pathophysiological Considerations for a Rational Surgical Choice." International Journal of Surgical Oncology 2012 (2012): 1–4. http://dx.doi.org/10.1155/2012/636824.
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Introduction. The best pancreatic anastomosis technique after pancreaticoduodenectomy (PD) is still debated. Pancreatic fistula (PF) is the most important complication but is also related to postoperative bleedings and pancreatic remnant involution. We support pancreaticojejuno anastomosis (PJ) advantages describing our technique with brief technical considerations.Materials and Methods. 89 consecutive patients underwent PD with suprapyloric gastric resection and double loop reconstruction. Pancreaticojejunal end-to-end anastomosis was done by simple invagination with a single layer of interrupted pledget-supported Ticron stitches.Results. Pancreatic fistula occurred in seven patients (7.8%): six cases of grade A fistula resolved spontaneously, and in only one case of grade B fistula percutaneous drainage was necessary. Postoperative hemorrhage occurred in only two (2.2%) of 89 patients.Conclusion. Pancreaticojejunostomy with minor changes in anastomotic techniques can contribute to improvement of the outcome of Roux-en-Y reconstruction regarding PF and other related complications. The particular reconstruction reported seems also to preserve the pancreatic exocrine function.
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Okoro, Philemon E., and Ngozi O. Onyeanunam. "Side-to-side penoscrotal anastomosis: a reliable technique for repair of recurrent urethrocutaneous fistula in male children." International Surgery Journal 8, no. 9 (2021): 2675. http://dx.doi.org/10.18203/2349-2902.isj20213594.
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Background: Surgical repair of urethrocutaneous fistulae (UCF) is relatively simple and results are often satisfactory. However, in some cases of UCF, recurrence results despite several attempts at repair. Reports are scanty on the management of such recalcitrant UCF. The aim of the study was to present our experience with recurrent UCF, and describes our technique of side-to-side penoscrotal anastomosis for repair of such fistulae.Methods: This was a 10 years analytical comparative study of the outcome of repair of recurrent UCF in paediatric patients using the simple double layer repair technique, and our technique of anastomosing the penis to the scrotum between 2008 and 2019 in our centre. Data obtained and analysed with SPSS 21 version included the number of previous attempts at repair, number, site and size of UCF, technique of repair, and the incidence of recurrence of UCF.Results: Nineteen patients were studied. Nine had conventional double layer repair of UCF with recurrence in 5 (55.6%). Two of the recurrent cases were added to the remaining 10 patients to make a total of 12 cases who had the staged repair by penoscrotal anastomosis (PSA) and there was no recurrence during the average follow up period of 1 year. P value was <0.05.Conclusions: Findings in this study suggest a superior outcome when the penoscrotal anastomosis is used for repair of recurrent UCF. We think it is better to apply this technique in cases of UCF which the surgeon considers potentially difficult than to wait to have a failed attempt before deploying it.
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Singh, Sohan Pal, Divya Prakash, Dheeraj Raj Baliyan, Virendra Kumar, Vishal Saxena, and Prachi. "A Prospective Comparative Study of Intestinal Anastomosis, Single Layer Extramucosal Versus Double Layer." International Journal of Contemporary Surgery 7, no. 2 (2019): 103. http://dx.doi.org/10.5958/2321-1024.2019.00032.1.
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Winston, David E. M., Nancy Pina, Tomasz Kasprzycki, Marium Gul-Muhammad, Robert Joyner, and Gopal C. Kowdley. "A Systematic Review of Single-Layer Versus Double-Layer Intestinal Anastomosis: Is One Better?" Journal of Surgical Research 302 (October 2024): 606–10. http://dx.doi.org/10.1016/j.jss.2024.07.105.
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MOHAMMAD A. ELIAN, M.D.*; MOATASEM, ASAAD A. ABDELAZIZ, M. D. *. "Single Layer Versus Double Layers Technique in Hand Sewn Intestinal Anastomosis: A Comparative Study,." Medical Journal of Cairo University 92, no. 06 (2024): 443–47. http://dx.doi.org/10.21608/mjcu.2024.371344.
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Tawar, Dr Rakesh, Dr Vikram Singh Mujalde, and Dr Sandeep Thakre. "Comparative Study of Different Anastomotic Technique- Single Layer Extra Mucosal Versus Conventional Double Layer Anastomosis in Elective and Emergency Laparotomy." IOSR Journal of Dental and Medical Sciences 13, no. 11 (2014): 63–65. http://dx.doi.org/10.9790/0853-131116365.
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Shinde, Nandkishor Dhanvantrao, Mohmmed Abdul Baseer, and Vaishnavi Koneru. "Single layer extramucosal versus double layer anastomosis for colostomy closure in children with anorectal malformation." International Journal of Surgery Science 5, no. 1 (2021): 630–33. http://dx.doi.org/10.33545/surgery.2021.v5.i1g.649.
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Saboo, Rahul, Satish Deshmukh, Rajiv Sonarkar, Vijay P. Agrawal, and Prateek Shah. "A comparative study of single layer continuous sutures versus double layer interrupted sutures in intestinal anastomosis." International Journal of Biomedical and Advance Research 6, no. 3 (2015): 264. http://dx.doi.org/10.7439/ijbar.v6i3.1729.
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Abdella, MohamedR, Mohamed Fathi, Alaa El-Sayed, and Adel Shehata. "Is single-layer better than double-layer interrupted intestinal anastomosis? A comparative study in pediatric patients." Egyptian Journal of Surgery 37, no. 1 (2018): 9. http://dx.doi.org/10.4103/ejs.ejs_78_17.
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Tudor, A., C. Molnar, C. Copotoiu, et al. "Pancreatico-Gastric Anastomosis with and without Sutures – Experimental Swine Model." Acta Medica Marisiensis 61, no. 2 (2015): 105–9. http://dx.doi.org/10.1515/amma-2015-0032.
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Abstract Objectives. The aim of our study is to identify a surgical technical that has the lowest rate of pancreatic fistulas in pancreatico-gastric anastomosis following duodenopancreatectomies. We studied pancreatico-gastric anastomosis performed with stitches compared to the ones performed without stitches. Methods. Our experimental model is based on ten piglets, which were divided into 2 groups. In the first group (n=5) the pancreatico-gastric anastomosis was done using double purse-string threads one passed through the gastric seromuscular layer and one through the gastric mucosa. In the second group (n=5) the pancreatico-gastric anastomosis was performed using sutures through the stomach and pancreas. Results. Postoperative amylasemia was higher in the second group. In the first group no pancreatico-gastric fistulas were observed, whereas pancreatic necrosis was observed only at a superficial level of the pancreatic stump. In the second group, two cases had developed fistulas, both bordered by large areas of coagulation necrosis accompanied by pancreatic duct hyperplasia. Duration of the anastomosis was shorter for the first group. Conclusions. In conclusion, the pancreatico-gastric anastomosis performed using two purse-string suture is a feasible, safe and fast process.
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Shumkovski, Aleksandar, Ljubomir Ognjenovic, and Stojan Gjoshev. "Comparison Between Dunking (Invagination) Pancreaticojejunoanastomosis and Double Layer Duct to Mucosa Anastomosis After Cephalic Duodenopancreatectomy-Whipple Procedure for Pancreatic Cephalic Carcinoma." PRILOZI 41, no. 3 (2020): 39–47. http://dx.doi.org/10.2478/prilozi-2020-0044.
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AbstractIntroduction: Pancreatic cancer is malignancy with poor prognosis for quality of life and overall survival. The incidence is variant, 7.7/100,000 in Europe, 7.6/100,000 in the USA, 2.2/100.000 in Africa. The only real benefit for cure is surgery, duodenopancreatectomy. The key points for this procedure are radicality, low morbidity and low mortality, the follow up and the expected overall survival. The benchmark of the procedure is the pancreaticojejunoanastomosis, with its main pitfall, postoperative pancreatic fistula B or C. Subsequently, the manner of creation of pancreaticojejunoanastomosis defines the safety, thus the postoperative morbidity and mortality. Finally, this issue remarkably depends on the surgeon and the surgical technique creating the anastomosis. We used 2 techniques with interrupted sutures, dunking anastomosis and duct-to-mucosa double layer technique. The objective of the study was to compare these 2 suturing techniques we applied, and the aim was to reveal the risk benefit rationale for dunking either duct to mucosa anastomosis.Material and method: In our last series of 25 patients suffering pancreatic head carcinoma we performed a standard dodenopancreatectomy. After the preoperative diagnosis and staging with US, CICT, tumor markers, they underwent surgery. Invagination-dunking anastomosis was performed in 15, whereas, duct-to-mucosa, double layer anastomosis was performed in 10. In the first group with dunking anastomosis, we had 6 patients with soft pancreas and 8 with narrow main pancreatic duct, less than 3 mm. In the duct-to-mucosa group there were 5 patients with soft pancreas and 4 with narrow main pancreatic duct. All other stages of surgery were unified, so the only difference in the procedure remained on the pancreatojejunoanastomosis. The onset of the postoperative pancreatic fistula was estimated with revelation of 3 fold serum level of alfa amylases from the third postoperative day in the drain liquid.Results: In the duct to mucosa group there wasn’t a clinically relevant postoperative pancreatic fistula, while in the dunking anastomosis group we had 4 postoperative pancreatic fistula B, 26 %. One of these 4 patients experienced intraabdominal collection – abscess, conservatively managed with lavation through the drain. Comparing the groups, there was no significant difference between the groups concerning the appearance of postoperative pancreatic fistula: p>0.05, p=0.125. From all 25 patients, in 21 patients biliary stent was installed preoperatively to resolve the preoperative jaundice. All 21 suffered preoperative and postoperative reflux cholangitis, extending the intra-hospital stay.Conclusion: So far, there have been many trials referring to opposite results while comparing these 2 techniques in creation of the pancreticojejunoanastomosis. In our study, the duct to mucosa anastomosis prevailed as a technique, proving its risk benefit rationale. However, further large randomized clinical studies have to be conducted to clarify which of these procedures would be the prime objective in the choice of the surgeon while creating pancreatojejunoanastomosis.
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TORRES, Orlando Jorge M., Roberto C. N. da Cunha COSTA, Felipe F. Macatrão COSTA, et al. "MODIFIED HEIDELBERG TECHNIQUE FOR PANCREATIC ANASTOMOSIS." ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) 30, no. 4 (2017): 260–63. http://dx.doi.org/10.1590/0102-6720201700040008.
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ABSTRACT Background : Pancreatic fistula is a major cause of morbidity and mortality after pancreatoduodenectomy. To prevent this complication, many technical procedures have been described. Aim: To present a novel technique based on slight modifications of the original Heidelberg technique, as new pancreatojejunostomy technique for reconstruction of pancreatic stump after pancreatoduodenectomy and present initial results. Method: The technique was used for patients with soft or hard pancreas and with duct size smaller or larger than 3 mm. The stitches are performed with 5-0 double needle prolene at the 2 o’clock, 4 o’clock, 6 o’clock, 8 o’clock, 10 o’clock, and 12 o’clock, positions, full thickness of the parenchyma. A running suture is performed with 4-0 single needle prolene on the posterior and anterior aspect the pancreatic parenchyma with the jejunal seromuscular layer. A plastic stent, 20 cm long, is inserted into the pancreatic duct and extended into the jejunal lumen. Two previously placed hemostatic sutures on the superior and inferior edges of the remnant pancreatic stump are passed in the jejunal seromuscular layer and tied. Results : Seventeen patients underwent pancreatojejunostomy after pancreatoduodenectomy for different causes. None developed grade B or C pancreatic fistula. Biochemical leak according to the new definition (International Study Group on Pancreatic Surgery) was observed in four patients (23.5%). No mortality was observed. Conclusion : Early results of this technique confirm that it is simple, reliable, easy to perform, and easy to learn. This technique is useful to reduce the incidence of pancreatic fistula after pancreatoduodenectomy.
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Di Eusanio, Marco, Paolo Berretta, Mariano Cefarelli, and Emanuele Gatta. "‘Double layer’ frozen elephant trunk with balloon endoclamping: a technique to simplify the 2-stage open repair of thoraco-abdominal aortic aneurysms." European Journal of Cardio-Thoracic Surgery 58, no. 2 (2020): 389–91. http://dx.doi.org/10.1093/ejcts/ezaa070.
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Abstract Staged replacement of the aortic arch and thoraco-abdominal aorta (TAA) with a frozen elephant trunk followed by TAA repair is a valuable treatment for patients with chronic TAA dissection. However, in patients with an unclampable descending thoracic aorta, the retrieval of the trunk can be problematic and the proximal stent graft-to-graft anastomosis technically challenging. Here we present our ‘double layer’ frozen elephant trunk technique to treat patients with TAA dissection.