Experience performing 64 consecutive stapled intestinal anastomoses in small children and infants
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Published on: April 17, 2020
Ian C S Mitchell1, Robert Barber, Anne C Fischer
1Department of Pediatric Surgery, Children's Medical Center of Dallas, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA.
Insights
Stapled intestinal anastomosis is effective in infants and children, offering a safe alternative to traditional hand-sewn methods. This technique shows promise for various pediatric surgical conditions.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
Background:
- Intestinal anastomosis in children traditionally uses hand-sewn techniques.
- Limited data exist on stapled anastomoses in pediatric populations.
Purpose of the Study:
- Evaluate the efficacy and safety of stapled intestinal anastomoses in infants and children.
- Assess outcomes of mechanical stapler use in pediatric gastrointestinal surgery.
Main Methods:
- Retrospective review of 64 pediatric patients undergoing stapled intestinal anastomosis over 5 years.
- Utilized a mechanical stapler for side-to-side functional end-to-end anastomosis.
- Documented postoperative outcomes and technique modifications.
Main Results:
- 64 children (median age 3 months) underwent stapled anastomosis.
- Complications included 2 wound infections and 1 anastomotic stricture.
- No issues of anastomotic dilatation or stasis were observed.
Conclusions:
- Stapled bowel anastomosis is an effective and safe approach for pediatric surgical diseases.
- The technique is applicable to newborns and infants requiring intestinal reconstruction.
Background/Purpose:
Intestinal anastomosis in children has traditionally been performed using hand-sewn techniques. Little data exist evaluating the efficacy of stapled intestinal anastomoses in the infant and pediatric populations.
Methods:
A review of a 5-year experience using a mechanical stapler to treat 64 consecutive children requiring intestinal anastomoses was performed. An intestinal stapler was used to complete a side-to-side functional end-to-end anastomosis. Postoperative outcomes and modifications made to the technique were identified.
Results:
Since 2004, 64 children (median age, 3 months; range, newborn to 24 months) underwent procedures requiring intestinal anastomosis. Twenty-six children (41%) were 1 week or less in age. Twenty-seven children (42%) underwent a stoma closure using a stapler. Thirty-seven children (58%) underwent bowel resection and stapled anastomosis in treating a variety of surgical disorders. Complications included wound infection (n = 2) and anastomotic stricture (n = 1). No issues suggesting anastomotic dilatation and subsequent stasis/overgrowth were identified.
Conclusions:
These results suggest that stapled bowel anastomosis is an effective approach applicable to a variety of surgical diseases in newborns and infants.
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