A Clinical Study – Resection and Anastomosis of Bowel in Our Surgical Practice

Resection and Anastomosis of Bowel in Our Surgical Practice

Keywords: Resection and anastomosis of bowel, leaks, intestinal healing, fecal fistula


Background: Anastomotic leaks are among the most dreaded complications after bowel surgery. In the present era, even with better understanding of the impact of local and systemic factors on anastomotic healing, dehiscence and leakage remains frequent and serious problem associated with high morbidity and mortality. However, problems with definitions and the retrospective nature of previous analyses have been major limitations. The aim of the study to use a prospective database to study the incidence of intestinal resection and anastomoses, to determine important factors and their significance in the healing of the anastomosis along with identifying the most ideal suture material for these techniques in our practice. Subjects and Methods: This study was carried out on 40 patients who underwent resection and anastomosis of bowel for various pathological causes in Kamineni Institute of Medical Sciences & Hospital Hyderabad during September 2018 to September 2019. Results: Out of the 40 patients who underwent resection and anastomosis of bowel, Anastomotic leaks were observed in 10 (25%) cases and all of them belonged to the group who were operated on emergency basis. Hypoproteinaemia, peritonitis and perioperative blood transfusions, hypovolemia were important attributable factors identified in the leak group. Minimal leaks were observed in the group of patients who were anastomosed with vicryl suture material alone. Mortality was observed in 3patients in the leak group. At 6 month follow up none of them developed anastomosis related complications like stenosis, diverticulum. Conclusion: The present study shows majority of the patients undergoing resection and anastomosis were dealt on an emergency basis. Multivariate analysis showed six predictive variables i.e., serum albumin less than 3 g/l, use of corticosteroids, bacterial peritonitis, malignancy, COPD, perioperative blood transfusions had a higher risk of developing anastomotic leaks. Vicryl when used alone being the suture material of choice.


Download data is not yet available.


Hautefeuille P. Gastrointestinal suturing: Apropos of 570 sutures performed over a 5-year period using a single layer continuous technique. Chirurgie. 1976;102(2):153–65.

Burch JM, Franciose RJ, Moore EE, Biffl WL, Offner PJ. Single-Layer Continuous Versus Two-Layer Inter- rupted Intestinal Anastomosis. Ann Surg. 2000;231(6):832– 837. Available from: https://dx.doi.org/10.1097/00000658- 200006000-00007.

Garude K, Tandel C, Rao S, Shah NJ. Single Layered Intestinal Anastomosis: A Safe and Economic Technique. Indian J Surg. 2013;75(4):290–293. Available from: https://dx.doi.org/10.1007/s12262-012-0487-7.

Khan R, Hameed F, Ahmed B, Dilawaiz M, Akram M. Intestinal anastomosis: comparative evaluation for safety, cost effectiveness, morbidity and complication of single versus double layer. Professional Med J. 2010;17(2):232–266.

Max E, Sweeney WB, Bailey HR, Oommen SC, Butts DR, Smith KW, et al. Results of 1,000 single-layer continuous polypropylene intestinal anastomoses. Am J Surg. 1991;162(5):461–467. Available from: https://dx.doi.org/10.1016/0002-9610(91)90262-c.

Hyman N, Manchester TL, Osler T, Burns B, Cataldo PA. Anastomotic Leaks After Intestinal Anastomosis. Ann Surg. 2007;245(2):254–258. Available from: https://dx.doi.org/10.1097/01.sla.0000225083.27182.85.

Ceraldi CM, Rypins EB, Monahan M, Chang B, Sarfeh IJ. Comparison of continuous single layer polypropylene anastomosis with double layer and stapled anastomoses in elective colon resections. Am J Surg. 1993;59(3):168–71.

Leslie A, Steele RJC. The interrupted serosubmucosal anastomosis - still the gold standard. Colorectal Dis. 2003;5(4):362–366. Available from: https://dx.doi.org/10.1046/j.1463-1318.2003.00460.x.

Askarpour S, Sarmast M, Peyvasteh M, Gholizadeh B. Comparision of single and double layer intestinal anastomosis in Ahwaz educational hospitals. Internet J Surg. 2005;23(2):45–54.

Waard D. Retinol may promote fluorouracil suppressed healing of experimental intestinal anastomoses. Arch Surg;130:1995– 2004.

Katz S. Bacterial adherence to surgical sutures. A possible factor in suture induces infection. Ann Surg. 1981;194:35–35.

Murphy JB. Cholecyst-intestinal, Gastro-intestinal, Entero- intestinal anastomosis, and approximation without sutures. Med Rec. 2017;42:665–71.