Single-layer end-on continuous suture of colonic anastomoses.

The single-layer end-on continuous suture technique for intestinal anastomoses on mobile intraperitoneal bowel segments is at least as safe and probably safer than a corresponding single-layer interrupted suture technique. Although the evaluation of this technique included a substantial number of surgeons who were performing their first anastomosis or who contributed only a single one to the series in a teaching university setting, there were no instances of clinical leak among 143 consecutive colonic anastomoses. Furthermore, 27 percent of the operations were performed as emergencies, thus optimal bowel preparation was lacking. The anastomosis time is distinctly shorter than the time needed for an interrupted single-layer technique, and contamination of the operative field is reduced to a minimum. The anastomosis is extremely simple, comfortable to perform, and reliable.