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    • A Comparative Study of Hand Sewn Small Intestinal Anastomosis; End to End Versus Side to Side Anastomosis

    Dina Hany1,*, MD, Wafi Fouad2,*, MD and Ramy Mikhael Nageeb1,*, MD
    *General Surgery department, Faculty of Medicine, Ain Shams University 1Lecturer of General Surgery, Faculty of Medicine, Ain Shams University 2Assistant Professor General Surgery, Faculty of Medicine, Ain Shams University

    Introduction: Bowel anastomosis can be classified depending on the site of anastomosis; enteroenteric, colocolic, ileocolic, colorectal, ileorectal, ileoanal, or coloanal, stapled or hand sewn or combined, single or double layered, interrupted or continuous and end to end or side to side. Aim of the study: To assess safety of end to end and side to side hand sewn small intestinal anastomosis. Patients and Methods: A prospective controlled study was conducted in the period from April 2014 to February 2016 consisting of 60 patients who underwent small intestinal resection and anastomosis in Ain Shams University hospitals. Patients were divided in 2 groups according to the type of the anastomosis; group A had 30 patients who underwent end to end anastomosis and group B had 30 patients who underwent side to side anastomosis. Results: anastomotic operative time was statistically significant to be higher in side to side anastomosis than end to end anastomosis after small intestinal resection, yet the overall operative time was statistically non significant. Anastomotic leakage although not statistically significant had higher incidence in hand sewn end to end anastomosis than side to side intestinal anastomosis after small intestinal resection. Other operative and postoperative results were insignificant. Conclusion: hand sewn side to side small intestinal anastomosis is safe, feasible and has lower anastomotic leakage rate than end to end anastomosis after small intestinal resection. Keywords: anastomosis, end to end, side to side, small bowel.

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