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Stapled intestinal anastomoses in infants

Lindsay Wrighton1, Jennifer L Curtis, Gerald Gollin

  • 1Division of Pediatric Surgery, Loma Linda University School of Medicine and Children's Hospital, Loma Linda, CA 92354, USA.

Journal of Pediatric Surgery
|December 2, 2008
PubMed

Insights

Stapled intestinal anastomoses in infants under 1 year are safe and effective, significantly reducing operative time compared to hand-sewn methods without increasing complications.

Area of Science:

  • Pediatric Surgery
  • Surgical Innovation
  • Gastrointestinal Surgery

Background:

  • Intestinal anastomoses are common in infants.
  • Hand-sewn techniques have been standard.
  • Stapled techniques offer potential advantages.

Purpose of the Study:

  • To compare stapled versus hand-sewn intestinal anastomoses in infants under 1 year.
  • To evaluate operative time, anastomotic failure, and mortality.
  • To assess safety and efficacy of stapled anastomoses in this age group.

Main Methods:

  • Retrospective review of 295 infants under 1 year undergoing intestinal anastomosis over 8 years.
  • Comparison of outcomes between stapled (n=106) and hand-sewn (n=189) anastomoses.
  • Data collected on operative time, anastomotic leak, stricture, obstruction, and death.

Main Results:

  • Stapled anastomoses were associated with significantly reduced operative time overall (102 vs 128 minutes) and for specific procedures.
  • No significant difference in anastomotic failure rates (leak, stricture, obstruction) between stapled and hand-sewn groups.
  • Stapled anastomoses were utilized in infants as small as 600g, though generally in older/larger infants.

Conclusions:

  • Stapled intestinal anastomoses are safe and effective in infants under 1 year when feasible based on intestinal size.
  • Stapled techniques offer a significant reduction in operative time, a key benefit in pediatric surgery.
  • The study supports the use of stapled anastomoses as a viable alternative to hand-sewn techniques in select infant populations.
Abstract

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