title: Single-layer continuous suture contributes to the reduction of surgical complications in digestive tract anastomosis involving special anatomical locations.
abstract: The key point of digestive cancer surgery is reconstruction and anastomosis of the digestive tract. Traditional anastomoses involve double-layer interrupted suturing, manually or using a surgical stapler. In special anatomical locations, however, suturing may become increasingly difficult and the complication rate increases accordingly. In this study, we aimed to investigate the feasibility and safety of a new manual suturing method, the single-layer continuous suture in the posterior wall of the anastomosis. Between January, 2007 and August, 2012, 101 patients with digestive cancer underwent surgery in Xi'an Gaoxin Hospital. Of those patients, 27 underwent surgery with the new manual method and the remaining 74 underwent surgery using traditional methods of anastomosis of the digestive tract. Surgical time, intraoperative blood loss, drainage duration, complications, blood tests, postoperative quality of life (QOL) and overall expenditure were recorded and analyzed. No significant differences were observed in surgical time, intraoperative blood loss, temperature, blood tests and postoperative QOL between the two groups. However, compared with the control group, the new manual suture group exhibited a lower surgical complication rate (7.40 vs. 31.08%; P=0.018), lower blood transfusion volume (274.07±419.33 vs. 646.67±1,146.06 ml; P=0.053), shorter postoperative hospital stay (14.60±4.19 vs. 17.60±6.29 days; P=0.038) and lower overall expenditure (3,509.85±768.68 vs. 6,141.83±308.90 renminbi; P=0.001). Our results suggested that single-layer continuous suturing for the anastomosis of the digestive tract is feasible and safe and may contribute to the reduction of surgical complications and overall expenditure.
authors.affiliation: Department of General Surgery, Xi'an Gaoxin Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710075, P.R. China.
authors.forename: Guo-Cai
authors.initials: GC
authors.lastname: Li
authors.affiliation: Department of General Surgery, Xi'an Gaoxin Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710075, P.R. China.
authors.forename: Yu-Chun
authors.initials: YC
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Xi'an Gaoxin Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710075, P.R. China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of General Surgery, Xi'an Gaoxin Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710075, P.R. China.
authors.forename: Fang-Cheng
authors.initials: FC
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Xi'an Gaoxin Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710075, P.R. China.
authors.forename: Wei-Hua
authors.initials: WH
authors.lastname: Huang
authors.affiliation: Department of General Surgery, Xi'an Gaoxin Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710075, P.R. China.
authors.forename: Jian-Qing
authors.initials: JQ
authors.lastname: Xu
authors.affiliation: Department of General Surgery, Xi'an Gaoxin Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi 710075, P.R. China.
authors.forename: Qing-Jiu
authors.initials: QJ
authors.lastname: Ma
keywords: anastomosis; continuous suture; gastric cancer; rectal cancer; single-layer