Single-layer anastomosis without hemostasis in the submucosa layer by electric coagulation or ligation: a novel technique of anastomosis for all gastrointestinal tracts.

Single-layer anastomosis has been used extensively for all gastrointestinal tracts around the world. Until now, most surgeons take for granted that submucous layers need careful hemostasis either by electric coagulation or ligation for the prevention of anastomotic stoma bleeding. We experienced hemostasis in the submucosa layer by adequate strength of anastomosis rather than electric coagulation for gastrointestinal tracts. In the present study the safety and benefit of this novel anastomotic technique was evaluated. From 1994 to 2006, 527 gastrointestinal anastomosis were performed using the improved anastomotic technique, and 281 anastomosis (control group) were completed with the commonly adopted technique. The improved anastomotic technique could decreased the incidence of leaks (p = 0.024), and the procedure time required for anastomosis in comparison to control group (p = 0.0002). The incidence of abscesses (p = 0.51) and bleeding (p = 1.00) of the improved anastomotic technique were no significantly different between the groups. The novel technique, single-layer anastomosis without hemostasis in the submucosa layer by electric coagulation or ligation, is suitable for all gastrointestinal anastomosises and it should be popularized.