Continuous single-layer gastrointestinal anastomosis: a prospective audit

Single-layer bowel anastomoses have conventionally been constructed using an interrupted suture technique. A single-layer continuous technique has been avoided on the grounds that it may predispose to ischaemia of the bowel ends. We have routinely used a single-layer continuous suture technique with an absorbable suture material (polyglycolic acid) to construct all recent intraperitoneal bowel anastomoses, and we present a 3-year audit of this technique. A total of 131 patients were studied of whom 66 had undergone upper gastrointestinal resections and 65 had had colonic resections. Twenty-two patients had emergency operations. Anastomotic failure was noted in 4.5 and 6.2 per cent of patients in each group respectively. The incidence of minor wound infection was 1.5 and 7.7 per cent respectively. The overall mortality rate was 8.4 per cent. This study suggests that a single-layer continuous suture technique gives acceptably reliable results when used in gastrointestinal anastomosis.