A Comparative Study of Single Layer Interrupted Extramucosal (Serosubmucosal) and Double Layer Intestinal Anastomosis

Abstract

Intestinal anastomosis is the establishment of communication between two formerly distant portions of the intestine. A significant proportion of the operations on the gastrointestinal tract involve the repair of the gut and it is this aspect of surgery of alimentary canal which is associated with dangerous complications. The breakdown of suture line or repaired site may result in peritonitis, fecal fistula and serious or fatal septic complications. Anastomotic breakdown remains a major cause of morbidity and mortality and prolonged stay after operations on the gastrointestinal tract. Of the various methods of intestinal anastomosis, two layered interrupted anastomosis using various types of suture material is the most common type used by surgeons worldwide. However, recently several reports have appeared advocating the benefits of single layer extramucosal (serosubmucosal) anastomosis which causes less narrowing of the lumen and maintains good vascularity of anastomotic site. Further, this anastomosis requires less time to fashion, costs less than any other method and have a lower risk of complications and leakage.