الفهرس | Only 14 pages are availabe for public view |
Abstract Aim of the work To evaluate the suitability of the one layer technique compared to the two layer technique for intestinal anastomosis. Conclusion The post operative complications in our study revealed no major statistical difference between the two groups as follow: post operative hemorrhage was found in 1 (3.3%) of patients of group I and no patients of group II develop this complication. It was due to slipped ligature of small mesenteric vessel and the patient was re-explored and the bleeding is controlled. Infection and septicemia was found in 5 (16.5%) of patients of group I and in 2 (6.6%) in group II. Two of them due to intra-abdominal residual abscess which are drained surgically and the other due to wound infection and treated by strong broad spectrum antibiotics. Residual abscesses found in 1 (3.3%) of patients of group I and in 1 (3.3%) of patients of group II, in both it is drained surgically. Wound dehiscence found in 5 (16.5%) of patients of group I and in 3 (9.9%) of patients of group II, they were due to wound infection and treated by strong broad spectrum antibiotics and then secondary sutures. Anastamotic leak found in 3 (9.9%) of patients of group I and in 2 (6.6%) of patients of group II. An intestinal fistula was found in 2 (6.6%) of patients of group I, both of them were colonic low output fistulae and managed conservative. And in 1 (3.3%) of patients of group II which was small intestinal high output fistulae and the patient was re-explored. Intestinal obstruction (stenosis, adhesions) was found in 2 (6.6%) of patients of group I and in 1 (3.3%) of patients of group II in both group it was adhesive obstruction and managed conservatively. Other complications (pulmonary embolism, stroke, DVT) found in 2 (6.6%) of patients of group I and in 3 (9.9%) of patients of group II in all of them it was DVT managed conservatively. The hospitals stay 7 to 21 in group I and 7 to 15 in group II. The present study demonstrates that a single-layer anastomosis is similar in terms of safety to the two layer technique, but that it can be constructed in a significantly shorter time and at a lower cost. These results also imply that the technique can be safely introduced into a surgical training program without a painful learning curve. Further, most of the anastomosis in this study were performed by residents, who were often unfamiliar with the technique or were performing their first intestinal anastomosis. |