A 6 years old boy experienced life threatening shock, his CT scan showed large amount of ascites, bowel wall thickening and poor or absent enhancement of the strangulated bowel segment, showing gangrenous bowel on surgical exploration. True about anastomosis is:
BOWEL ANASTOMOSES Lembe described seromuscular suture technique for bowel anastomosis in 1826Q Senn advocated a two-layer technique for closureQ Halsted ored a one-layer extramucosal closureQ Connell used a single layer of interrupted sutures incorporating all layers of the bowelQ Kocher's method, a two layers anastomosis, first a continuous all-layer suture using catgut, then an inveing continuous (or interrupted) seromuscular layer suture using silk, became the standard. There is evidence that inversion is safest in bowel (least likely to leak) although end-to-end staplers give an eveed anastomosis without complication. The single-layer extramucosal anastomosis, advocated by MathesonQ, causes the least tissue necrosis or lummal narrowing The Cheatle split (making a cut into the anti-mesenteric border) may help to enlarge the lumen of distal, collapsed bowelQ Bowel anastomotic leaks are generally occurred on day 7Q
Should be done by continuous layers as it takes less time
Should be done with catgut
Should be done by single layer seromuscular Lembe sutures
Should be done by single layer taking submucosa
NEET 2018