A Comparative Study to Assess the Bowel anastomosis Using Double Layered and Single Layered Closure

Background: Bowel resection and anastomosis address various conditions, including bowel gangrene, polyps, intussusceptions, roundworm infestation with obstruction, tuberculosis with stricture or perforation, and traumatic perforations. Traditional two-layer intestinal anastomosis is time-consuming and intricate, while the single-layer method is quicker and cost-effective, albeit with safety concerns. The objective is to analyze better technique for bowel anastomosis by comparing the single layered versus double layered anastomosis. This study compares pain scores and post-operative nausea vomiting in single layered and double layered anastomosis. Material and Methods: The study spanned 12 months, involving 50 patients undergoing small and large bowel resection and anastomosis. After fulfilling inclusion and exclusion criteria, patients were randomized into Group 1 (single-layer anastomosis) or Group 2 (double-layer anastomosis). Pain and postoperative nausea and vomiting were noted in the early postoperative period. The pain was assessed using Numerical Rating Pain score of 10 units, where zero indicated ‘no pain' and 10 indicated ‘most severe or worst pain'. Severity of nausea was assessed as mild, moderate and severe in terms of interference with daily activities. Results: Group 1 experienced mild pain (52%), while Group 2 reported moderate pain (48%). Mild postoperative nausea and vomiting were frequent. Anastomosis took less time in Group 1 (17.24 ± 2.80 minutes) than Group 2 (28.12 ± 2.19 minutes) (P<0.05). Hospital stays were similar. Group 1 had 3 anastomotic leaks and 1 wound infection, while Group 2 had 2 leaks and 2 wound infections. A slightly higher anastomotic leak prevalence in Group 1 lacked statistical significance. Conclusion: Single-layer closure demonstrated quicker recovery, better pain scores than double layered closure.