Singh Rommel, Najmi Husain I, Chahal Reetinder K, Nikhil Dehankar
Department of General Surgery, Government Medical College (GMC) and Rajindra Hospital, Patiala, IND.
Cureus. 2022 Mar 12;14(3):e23088. doi: 10.7759/cureus.23088. eCollection 2022 Mar.
Intestinal perforations requiring resection anastomosis of the gastrointestinal tract (GIT) or the formation and closure of temporary intestinal stoma are prevalent worldwide. This prospective comparative study was done to assess the efficacy and safety of single-layered anastomosis compared to a double-layered anastomosis.
Patients undergoing intestinal anastomosis with either of these two techniques were observed prospectively for various outcome parameters like time taken for anastomosis, and that for entire surgery, postoperative complications, etc. Data obtained were analyzed for statistical significance by applying the chi-square test and student's "t-test."
Duration for fashioning the anastomosis was significantly lesser for a single layer anastomosis than double (mean [±SD] for single layer was 19.57 ± 2.25 minutes and for double layer group was 30 ± 2.59 minutes, p=0.002). There was no statistical difference in the postoperative complications between the two groups. The postoperative incomplete intestinal obstruction was reported in three cases of the double layer group.
Single-layered gastrointestinal anastomosis (GIA) resulted in a significant reduction in time, without any difference in complications. Additionally, it is easier to train surgical residents in the single-layered technique which is particularly important in the setting of a teaching institute and can be recommended for intestinal anastomosis.
需要进行胃肠道切除吻合术或临时肠造口的形成与闭合的肠穿孔在全球范围内都很常见。本前瞻性比较研究旨在评估单层吻合术与双层吻合术相比的疗效和安全性。
对采用这两种技术之一进行肠吻合术的患者进行前瞻性观察，观察吻合时间、整个手术时间、术后并发症等各种结局参数。通过应用卡方检验和学生“t检验”对获得的数据进行统计学意义分析。
单层吻合术构建吻合口的时间明显短于双层吻合术（单层的平均[±标准差]为19.57±2.25分钟，双层组为30±2.59分钟，p=0.002）。两组术后并发症无统计学差异。双层组有3例报告术后不完全性肠梗阻。
单层胃肠道吻合术（GIA）可显著缩短时间，且并发症无差异。此外，单层技术更容易培训外科住院医师，这在教学机构环境中尤为重要，可推荐用于肠吻合术。
