[Single or double layer? A controlled prospective study on the comparison of 2 suture technics in gastrointestinal...

In a controlled clinical trial in 165 patients single layer anastomoses (n = 103) were compared to two layer anastomoses (n = 62). All anastomoses were controlled radiologically. The rate of dehiscence was 7.7% (n = 8) for the single layer group, 6.5% (n = 4) for the two layer group. Six patients died, 3 of both groups (2.9%:4.8%). There was no significant difference. However, for gastrectomies and anastomoses of small and large bowel single layer anastomoses seem to be preferable, for partial gastric resection two layer anastomoses. Factors predisposing for anastomotic breakdown are: age beyond 50, colo-rectal anastomoses, protein levels beyond 6 mg%, carcinosis peritonei.