Single Layered Versus Double Layered Intestinal Anastomosis: A Randomized Controlled Trial

Area of Science:

• Surgical Techniques
• Gastrointestinal Surgery
• Comparative Effectiveness Research

Background:

• Gastrointestinal anastomosis is a frequent surgical procedure across various specialties.
• The comparative safety and efficacy of single-layer versus double-layer techniques remain unclear.

Purpose of the Study:

• To compare the efficacy, safety, and cost-effectiveness of single-layer versus double-layer intestinal anastomosis.
• To evaluate key outcomes including operative time, complications, hospital stay, and cost.

Main Methods:

• A prospective, double-blind, randomized controlled trial involving 97 patients undergoing intestinal resection and anastomosis.
• Patients were randomized to either single-layer extramucosal anastomosis (Group-A) or double-layer anastomosis (Group-B).
• Outcomes measured included anastomosis time, postoperative complications, hospital stay duration, suture material cost, and bowel function return.

Main Results:

• Single-layer anastomosis (Group-A) showed significantly shorter anastomosis times (15.12±2.27 min vs. 24.38±2.26 min) and hospital stays (5.90±1.43 days vs. 7.29±1.89 days) compared to double-layer (Group-B) (p<0.001).
• Quicker return of bowel function was observed in the single-layer group (2.42±1.11 days vs. 3.1±1.34 days).
• No significant difference in complication rates was found between the groups, though suture material cost was higher in the single-layer group.

Conclusions:

• Single-layer extramucosal continuous intestinal anastomosis is as safe as the double-layer method.
• This technique may be more cost-effective and offers advantages in reduced operative time and hospital stay.
• Single-layer anastomosis could be the optimal choice for routine surgical practice.