[Continuous single-layer technique in turnable and nonturnable gastrointestinal anastomoses. A prospective observational study of emergency and elective operations].
First reports about the continuous single-layer technique for gastrointestinal anastomosis have shown advantages regarding shorter time for construction and lower costs without a higher complication rate. This prospective observational study was conducted to prove the safety of routine use of the continuous single-layer technique for gastrointestinal anastomosis. All consecutive patients operated upon in the abdomino-surgical department of a community hospital in a period of 5 years with resections of the stomach, small and large bowel or upper third of the rectum were included in this study. All gastrointestinal anastomoses were performed by continuous single-layer technique using 3/0 or 4/0 absorbable PDS suture. Follow-up was until hospital discharge. 344 patients received 405 anastomoses, 30 % were emergency and 70 % elective operations. 6 anastomotic leaks (1.7 %) and 1 stenosis (0.2 %) occurred, two patients died after reoperation followed by multiple organ failure. 30-day-mortality was 12 % due to a high percentage of emergency operations, of patients with late stage malignancy, and multimorbidity or old age. The continuous single-layer technique for gastrointestinal anastomosis is safe in routine clinical practice and should receive broader attention due to its advantages.
Littke
M P
MP
Chirurgische Abteilung, St. Elisabeth-Hospital, Iserlohn, Kooperierende Klinik für Chirurgie der Universität Witten/Herdecke, Germany. Marian.Littke@t-online.de
Markgraf
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000714:Anastomosis, Surgical; D017558:Elective Surgical Procedures; D004630:Emergencies; D005260:Female; D005767:Gastrointestinal Diseases / Q000401:mortality / Q000601:surgery*; D005770:Gastrointestinal Neoplasms / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D011446:Prospective Studies; D015996:Survival Rate; D013536:Suture Techniques