Single Layer Extra-Mucosal Versus Double Layer Intestinal Anastomosis for Colostomy Closure: A Prospective Comparative Study

Background: The main objective was to compare the outcome of single layer interrupted extra-mucosal sutures with that of double layer suturing in the closure of colostomies. Subjects and Methods: Sixty-seven patients with closure colostomy were assigned in a prospective randomized fashion into ei...

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Main Authors: Layth Saleh Owaid, Imad Wajeeh Al-Shahwani, Zuhair B. Kamal, Laith Naif Hindosh, Abbas Farman Abdulrahman, Haider Salim Mihson
Format: Article
Language:English
Published: University of Baghdad/ Al-Kindy College of Medicine 2021-09-01
Series:مجله كليه طب الكندي
Subjects:
Online Access:https://jkmc.uobaghdad.edu.iq/index.php/MEDICAL/article/view/274
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author Layth Saleh Owaid
Imad Wajeeh Al-Shahwani
Zuhair B. Kamal
Laith Naif Hindosh
Abbas Farman Abdulrahman
Haider Salim Mihson
author_facet Layth Saleh Owaid
Imad Wajeeh Al-Shahwani
Zuhair B. Kamal
Laith Naif Hindosh
Abbas Farman Abdulrahman
Haider Salim Mihson
author_sort Layth Saleh Owaid
collection DOAJ
description Background: The main objective was to compare the outcome of single layer interrupted extra-mucosal sutures with that of double layer suturing in the closure of colostomies. Subjects and Methods: Sixty-seven patients with closure colostomy were assigned in a prospective randomized fashion into either single layer extra-mucosal anastomosis (Group A) or double layer anastomosis (Group B). Primary outcome measures included mean time taken for anastomosis, immediate postoperative complications, and mean duration of hospital stay. Secondary outcome measures assessed the postoperative return of bowel function, and the overall mean cost. Chi-square test and student t-test did the statistical analysis.. Results:  Thirty-two patients were allocated to group A and 35 patients to group B. The mean time taken for anastomosis was significantly shorter in group A (23.25 ± 1.20 min in group A vs. 36.71 ± 1.93 min in group B; P<0.001). A significant shorter duration of hospital stay was seen in group A (7.00 ± 1.778 days in group A vs. 9.74 ± 1.990 days in group B; P<0.001). The detection of bowel sound was substantially quicker in group A as compared to group B (4.56 ± 0.50 days in group A vs. 6.46±0.50 days in group B; P<0.001). There was no significant discrepancy between the two groups regarding anastomotic leak rates (P= 0.543). The mean cost of double layer intestinal anastomosis method was significantly higher than that of single layer anastomosis (P<0.001). Conclusions: The use of single layer extra-mucosal anastomosis of the intestine has the advantage of taking less time, less morbidity and cost-effective to perform with the same rate of anastomotic leak in the closure of colostomy.
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spelling doaj.art-122b1605aae84442ac1eac41ba3e02bb2022-12-21T22:40:05ZengUniversity of Baghdad/ Al-Kindy College of Medicineمجله كليه طب الكندي1810-95432521-43652021-09-01172959910.47723/kcmj.v17i2.274274Single Layer Extra-Mucosal Versus Double Layer Intestinal Anastomosis for Colostomy Closure: A Prospective Comparative StudyLayth Saleh Owaid0Imad Wajeeh Al-Shahwani1Zuhair B. Kamal2Laith Naif Hindosh3Abbas Farman Abdulrahman4Haider Salim Mihson5Al-kindy Teaching Hospital, Risafah Health Directorate, Baghdad, IraqAl-Kindy College of Medicine, University of Baghdad, Baghdad, IraqAl-Kindy College of Medicine, University of Baghdad, Baghdad, IraqAl-Kindy College of Medicine, University of Baghdad, Baghdad, IraqAl-kindy Teaching Hospital, Risafah Health Directorate, Baghdad, IraqAl-kindy Teaching Hospital, Risafah Health Directorate, Baghdad, IraqBackground: The main objective was to compare the outcome of single layer interrupted extra-mucosal sutures with that of double layer suturing in the closure of colostomies. Subjects and Methods: Sixty-seven patients with closure colostomy were assigned in a prospective randomized fashion into either single layer extra-mucosal anastomosis (Group A) or double layer anastomosis (Group B). Primary outcome measures included mean time taken for anastomosis, immediate postoperative complications, and mean duration of hospital stay. Secondary outcome measures assessed the postoperative return of bowel function, and the overall mean cost. Chi-square test and student t-test did the statistical analysis.. Results:  Thirty-two patients were allocated to group A and 35 patients to group B. The mean time taken for anastomosis was significantly shorter in group A (23.25 ± 1.20 min in group A vs. 36.71 ± 1.93 min in group B; P<0.001). A significant shorter duration of hospital stay was seen in group A (7.00 ± 1.778 days in group A vs. 9.74 ± 1.990 days in group B; P<0.001). The detection of bowel sound was substantially quicker in group A as compared to group B (4.56 ± 0.50 days in group A vs. 6.46±0.50 days in group B; P<0.001). There was no significant discrepancy between the two groups regarding anastomotic leak rates (P= 0.543). The mean cost of double layer intestinal anastomosis method was significantly higher than that of single layer anastomosis (P<0.001). Conclusions: The use of single layer extra-mucosal anastomosis of the intestine has the advantage of taking less time, less morbidity and cost-effective to perform with the same rate of anastomotic leak in the closure of colostomy.https://jkmc.uobaghdad.edu.iq/index.php/MEDICAL/article/view/274single layer anastomosisdouble layer anastomosisclosure colostomy
spellingShingle Layth Saleh Owaid
Imad Wajeeh Al-Shahwani
Zuhair B. Kamal
Laith Naif Hindosh
Abbas Farman Abdulrahman
Haider Salim Mihson
Single Layer Extra-Mucosal Versus Double Layer Intestinal Anastomosis for Colostomy Closure: A Prospective Comparative Study
مجله كليه طب الكندي
single layer anastomosis
double layer anastomosis
closure colostomy
title Single Layer Extra-Mucosal Versus Double Layer Intestinal Anastomosis for Colostomy Closure: A Prospective Comparative Study
title_full Single Layer Extra-Mucosal Versus Double Layer Intestinal Anastomosis for Colostomy Closure: A Prospective Comparative Study
title_fullStr Single Layer Extra-Mucosal Versus Double Layer Intestinal Anastomosis for Colostomy Closure: A Prospective Comparative Study
title_full_unstemmed Single Layer Extra-Mucosal Versus Double Layer Intestinal Anastomosis for Colostomy Closure: A Prospective Comparative Study
title_short Single Layer Extra-Mucosal Versus Double Layer Intestinal Anastomosis for Colostomy Closure: A Prospective Comparative Study
title_sort single layer extra mucosal versus double layer intestinal anastomosis for colostomy closure a prospective comparative study
topic single layer anastomosis
double layer anastomosis
closure colostomy
url https://jkmc.uobaghdad.edu.iq/index.php/MEDICAL/article/view/274
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