Background: Conventional double layered technique of intestinal anastomosis are widely in practise. Some surgeons also practice single layer technique either continuous or interrupted. This was a prospective observational study to compare safety, efiicacy and feasibility of single versus double layered continuous techniques.Methods: Patients undergoing intestinal anastomosis with either of these two techniques were observed prospectively for various outcome parameters like length of suture material used, time taken for anastomosis, and that for entire surgery, postoperative complications, return of bowel activity etc. Data such obtained was analysed for statistical significance by applying chi-square test and unpaired ‘t’ test.Results: Length of suture used for single layer (mean of 15.06 cm) was statistically significantly lesser than that for double layer (mean 19.90 cm) (p.0.001). Time taken for anastomosis and overall surgical time too was significantly less for single layer group (p.0.001 and 0.022 respectively). Complications including anastomotic dehiscence were not significantly different between two groups. Postoperative recovery of bowel function was earlier in single layer group with marginal statistical significance (p=0.048).Conclusions: Thus in our study, single layer continuous method of intestinal anastomosis resulted in significant reduction in time, suture material length and cost; without any difference in complications and it marginally hastens the postoperative recovery of bowel function. So single layer continuous method can be recommended for intestinal anastomosis.
Aspergillus endocarditis is a rare entity in an immunocompetent host with native valves. Late or misdiagnosis leads to increased morbidity and mortality. In this report authors present a case of native valve Aspergillus endocarditis, in 30-year-old male immunocompetent patient with no co-morbidities. The patient also had a parietal glioma. He underwent four surgeries including valve replacement during the course of illness. Patient improved with appropriate antifungal therapy and surgeries. He was on suppressive antifungals and continued to do well. Aspergillus endocarditis is to be considered in culture negative endocarditis. The optimal management includes adequate surgical debridement in conjunction with prolonged antifungal therapy.
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