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Published on: November 30, 2010
Complications of mechanical suturing in pediatric patients
Girolamo Mattioli1, Marco Castagnetti, Paolo Repetto
1Department of Pediatric Surgery, Giannina Gaslini Research Institute, University of Genova, Genova, Italy.
Insights
Mechanical suturing in pediatric surgery is generally safe, with a low complication rate. Endoscopic staplers demonstrated a safer profile compared to linear staplers, suggesting wider applicability.
Area of Science:
- Pediatric surgery
- Surgical innovation
- Gastrointestinal surgery
Background:
- Mechanical suturing is recognized for reducing operative time in surgery.
- Complications associated with stapler use in pediatric patients require further definition.
Purpose of the Study:
- To evaluate the safety and efficacy of mechanical suturing devices in pediatric surgical procedures.
- To compare complication rates between different types of staplers used in children.
Main Methods:
- A retrospective review of 174 pediatric procedures utilizing circular or linear staplers between 1996 and 2001.
- Recording and analysis of intraoperative and early postoperative complications for each intervention.
Main Results:
- An overall complication rate of 6.9% (12/174) was observed.
- Major complications included leakage, bleeding, and bronchopleural fistula.
- Endoscopic staplers were associated with a significantly lower complication rate compared to conventional linear staplers (P <.05).
Conclusions:
- Mechanical suturing is a viable and safe option in pediatric surgery, despite infrequent use.
- Certain procedures employing mechanical suturing could be adopted more broadly due to their speed and safety profile.
Background/Purpose:
Although it is widely accepted that staplers are effective in reducing operating time, potential complications related to their use in the pediatric population are not well defined yet. The aim of this study is to evaluate the safety of mechanical suturing.
Methods:
Between 1996 and 2001, 174 procedures were performed using circular staplers in gastrointestinal anastomosis, whereas linear staplers were used in gastrointestinal and lung resection. Intraoperative and early complications of each intervention were recorded.
Results:
Overall, 12 complications occurred (6.9%). Two were caused by technical problems: In one case the stapler broke, in the other the anvil detached from the instrument shaft. Ten (5.7%) were major complications: 2 cases of leakage and 3 of bleeding in gastrointestinal procedures, and one case of bronchopleural fistula and 4 cases of bleeding during lung surgery. There was a significant correlation (P <.05) between type of stapler used and development of complications, suggesting a safer use of endoscopic staplers compared with conventional linear ones.
Conclusions:
Mechanical suturing in children is not used frequently, but some procedures could be used more widely because they are fast and safe.
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