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.