Single Layer Versus Double Layers Technique in Hand Sewn Intestinal Anastomosis: A Comparative Study,

Background: Gastrointestinal anastomosis is considered a step in the surgeons’ daily practice that has a lot of debates. There are several techniques used, but hand sewn remains the gold standard for anastomosis. It has been a controversy regard-ing the outcomes of single layer or double layers anastomosis. Aim of Study: The aim of this study is to compare outcomes regarding the efficiency, safety and the cost effectiveness asso-ciated with each technique. Patients and Methods: The study included 100 patients in-dicated for intestinal anastomosis at El-Minia University Hos-pital and Suad Kafafi University Hospital between June 2022 and June 2023. The patients were randomized into two equal groups; group A for single layer intestinal anastomosis (SLIA) and group B for double layers intestinal anastomosis (DLIA). Patients aged ≥18 years indicated for elective or emergency in-testinal anastomosis for different causes were included. Post-operatively, all the patients were assessed for anastomotic leak. Also, duration required to perform the intestinal anastomosis, hospital stay, morbidity and mortality were assessed. Rate of anastomotic leak was the primary outcome while length of hos-pital stay and other complications were considered the second-ary outcome measures. Results: Enteroenteric anastomosis was the commonest. Eighty patients underwent elective surgery and 20 patients underwent emergency surgery. The duration of anastomosis was significantly shorter in group A (p=0.00). There were 3 anastomotic leaks; one in group A (2%) and 2 in group B (4%) (p=0.55). Seroma and SSI were recorded postoperatively in the initial 3 months. There was 1 death in each group due to septic shock after leak. Hospital stay in group A was comparable to that of group B (p=0.92). Conclusion: SLIA has proved safety and feasibility with-significant reduction in duration of anastomosis and was com-parable to the DLIS in postoperative outcome.