Single Interrupted Extramucosal Suturing of the Bowel is a Safe Surgical Technique

Abstract

Background: Leakage from an anastomosis in the gastrointestinal tract is a major complication that is often associated with increased mortality, morbidity and prolonged stay. Different techniques of intestinal anastomosis are present:

• Sutured

– Single-layer (interrupted or continuous)

– Two-layered

• Stapled

Controversy regarding single versus double layer anastomosis goes as back as 1887 when Halsted proposed interrupted extra mucosal suturing.

Aim of the study: To evaluate the safety of the technique single interrupted extramucosal suturing of the bowel.

Patients and Method: This is a prospective study of 60 patients undergoing intestinal surgery over a period of one year and 9 months (January 2009-september 2010) in baquba teaching hospital; Both of emergency and elective surgeries are included in the study.

The way of bowel suturing (perforation or anastomosis) used was single interrupted extramucosal using two zero vycril (polyglactine).

Results: No single patient developed anastomosis dehiscence or fecal fistula and they all tolerated early oral feeding.

Conclusion: Single-layer sero-submucosal (extramucosal) technique is safe, easy to perform, simply to taught and with no anastomosis-related morbidity and mortality. It can also be accomplished in shorter time.