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Related Experiment Videos

Single-layer continuous versus two-layer interrupted intestinal anastomosis: a prospective randomized trial.

J M Burch1, R J Franciose, E E Moore

  • 1Department of Surgery, Denver Health Medical Center, Denver, Colorado 80204-4507, USA. jburch@dhha.org

Annals of Surgery
|May 19, 2000
PubMed
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A single-layer continuous intestinal anastomosis is faster, cheaper, and as safe as the two-layer technique. This method can be safely integrated into surgical training programs without increasing patient complications.

Area of Science:

  • Surgical innovation
  • Gastrointestinal surgery
  • Surgical education

Background:

  • Continuous single-layer intestinal anastomosis is increasingly advocated.
  • Potential benefits include reduced construction time, lower costs, and fewer anastomotic leaks.
  • This study evaluated its safety and efficacy in a surgical training setting.

Purpose of the Study:

  • To assess the suitability of a single-layer continuous technique for intestinal anastomosis within a surgical training program.
  • To compare its time, cost, and complication rates against the traditional two-layer interrupted anastomosis.

Main Methods:

  • A randomized study over 3 years (ending Sept 1999) included adult patients requiring intestinal anastomosis (excluding stomach, duodenum, rectum).
  • Patients were assigned to single-layer (3-0 polypropylene) or two-layer (3-0 silk Lembert outer, 3-0 polyglycolic acid inner) techniques.

Related Experiment Videos

  • Anastomotic leak was defined by radiographic evidence, wound drainage, or visible suture line disruption.

    • Main Results:

    • 65 single-layer and 67 two-layer anastomoses were performed with comparable patient demographics.
    • Leak rates were 3.1% (single-layer) vs. 1.5% (two-layer); abscess rates were 3.0% in both groups.
    • Mean anastomosis time was 20.8 min (single-layer) vs. 30.7 min (two-layer); material costs were $4.61 vs. $35.38, respectively.

    Conclusions:

    • Single-layer continuous anastomosis is significantly faster and comparable in complication rates to the two-layer technique.
    • This method offers substantial cost savings.
    • It can be safely incorporated into surgical training programs without increasing complication rates.