Single-layer continuous versus single-layer interrupted extra mucosal techniques in small intestine anastomosis

Background: intestinal anastomosis is a commonly performed surgical procedure both in emergency and elective settings in surgical practice therefore its leak and disruption is a common cause of post operative mortility and morbidity and economical burden. gut anastomosis heals by same mechanism like that of wound healing. the submucosa,is the strongest layer of gut wall therefore ideal anastomotic technique is the one which includes apposition and approximation of this layer. aim: to find out the outcome of a single-layer continuous extra mucosal technique as compared to interrupted for the anastomosis of small bowel to be created. methods: this was a prospective study based on randomization and was carried out in surgical b unit,lady reading hospital peshawar from 1st may 2012 to 31st december 2012. total fifty patients were included in study requiring small intestine anastomosis and were divided in two groups based on randomization. group i included those patients in which the anastomosis performed by single layer continuous extra mucosal technique and group ii patients underwent single layer interrupted extramucosal technique for creation of anastomosis,group i included 24 patients (n=24) and group ii 26 patients (n=26) . the demographic features,time taken to create anastomosis,postoperative complications,number of deaths if any and hospital stay in days were recorded on a printed proforma and data analysis was done through computer soft ware spss 16. results: group i and ii were similar as for as the demographic features,postoperative complications and duration of hospital stay are concerned. 4.2% patients of group i and 7.7% of group ii developed anastomotic dehiscence with non significant p value. mean time taken for creation of anastomosis was 10.04 minutes in continuous extra mucosal anastomosis group (group i) and 19.2 minutes in interrupted extra mucosal anastomosis [group ii ] (p=0.0001) overall hospital mortality was 2%. conclusion: single layer continuous extra mucosal technique is as safe as interrupted extra mucosal anastomosis technique but can be performed in shorter time and can be a cost effective alternative for construction of bowel anastomosis.