[Comparative study on single layer and two layer anastomoses of small intestine (author's transl)]

Abstract

The one layer anastomosis after Gambee is compared with the two layer anastomosis after Dick at the small bowel of 20 minipigs. The end-to-end anastomosis after Gambee consists of an interrupted, inverting suturing of the bowel wall. Dick suggested a closed method, applying bronchial clamps before resecting the bowel. Seromuscular sutures and inner all layer sutures are inserted interrupted. Experimental studies have been done after 4, 7, 14 and 21 days. In Histology two layer anastomoses caused delayed wound healing after 4 days. Twenty-one days after the operation histological findings in both groups were equal. Microangiographic studies showed, that in single layer anastomoses revascularization began 3 days earlier than in two layer anastomoses. Measuring of the bursting strength showed no significant differences. All parameters suggest equal value of both techniques. In our opinion the two layer anastomosis after Dick combines the advantages of a closed method with a simple, easy performable technique. We therfore apply it all over the gastrointestinal tract with exception of esophagel and rectal anastomoses.