The comparison of anastomosis strength and leakage between double-layer full-thickness and single-layer extramucosal intestine anastomosis

Various intestine anastomosis techniques have been studied and used, but which is best is still debated. In our center, double-layer full-thickness intestine anastomosis was still considered as standard. However, a single-layer extramucosal intestine anastomosis has shown favorable results. This stu...

Full description

Saved in:

Bibliographic Details
Published in:	Annals of medicine and surgery Vol. 85; no. 8; pp. 3912 - 3915
Main Authors:	Warsinggih, Akil, Fardah, Lusikooy, Ronald E, Ulfandi, Devby, Faruk, Muhammad, Hendarto, Joko, Jalil, Muhammad R, Sinangka, Andi A M, Abdi, Amirullah
Format:	Journal Article
Language:	English
Published:	England Lippincott Williams & Wilkins 01-08-2023
Subjects:	Original Research end-to-end experimental study all layer surgical anastomosis seromuscular
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Various intestine anastomosis techniques have been studied and used, but which is best is still debated. In our center, double-layer full-thickness intestine anastomosis was still considered as standard. However, a single-layer extramucosal intestine anastomosis has shown favorable results. This study created an anastomotic model to compare the anastomosis strength and leakage between double-layer full-thickness and single-layer extramucosal intestine anastomosis. This experimental study was performed in 20 randomized healthy male pigs, to be included either in Group A (Single-layer extramucosal intestine anastomosis) or Group B (Double-layer full-thickness intestine anastomosis). Enterotomy followed by an end-to-end anastomosis suture was performed in the jejunum. Fourteen days after the operation, any anastomosis leakage and its location was documented. The anastomosis strength was evaluated using manometry. Data were compared between groups using the Mann-Whitney and Fischer Exact test, considering a significance level of <0.05. The overall mean intraluminal anastomotic bursting pressure was 4,257±1,185. Group A had a higher intraluminal anastomotic bursting pressure but was not statistically significant compared to group B (4.726±0.952 vs. 3.787±1.252 kilopascals, =0.063). One leakage (5%, antimesenteric area) occurred in Group A and three leakages (15%, antimesenteric and mesenteric area) occurred in Group B. However, statistical analysis with Fischer exact showed no significant difference of leakage rate between those groups ( =0.291). The anastomosis strength and leakage did not differ significantly between the single-layer extramucosal intestine anastomosis group and the double-layer full-thickness anastomosis group. However, the location of leakage was most common in the antimesenteric area in the double-layer full-thickness anastomosis group.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2049-0801 2049-0801
DOI:	10.1097/MS9.0000000000001072