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Stapled intestinal anastomosis is a simple and reliable method for management of intestinal caliber discrepancy in
Kaori Sato1, Hiroo Uchida, Yujiro Tanaka
1Department of Pediatric Surgery, Saitama Children's Medical Center, 2100 Magome, Iwatsuki, Saitama, Saitama, 339-8551, Japan.
Insights
Stapled intestinal anastomosis is safe and effective in children, showing no intraoperative complications and comparable postoperative outcomes to hand-sewn methods. This technique offers shorter surgery times for specific pediatric conditions.
Area of Science:
- Pediatric Surgery
- Surgical Innovation
- Gastrointestinal Surgery
Background:
- Minimally invasive surgery is increasing, driving the need for advanced techniques like stapled intestinal anastomosis.
- Surgical instruments for stapled anastomosis are becoming suitable for pediatric patients with small intestinal lumens.
Purpose of the Study:
- To review and compare intraoperative and postoperative outcomes of stapled versus hand-sewn intestinal anastomoses in pediatric patients.
- To evaluate the safety and efficacy of stapled anastomosis in neonates, infants, and children.
Main Methods:
- Retrospective analysis of operative data from children undergoing stapled or hand-sewn anastomoses (March 2005 - December 2011).
- Comparison groups included patients with anorectal malformation (colostomy closure) and ileal atresia.
Main Results:
- No intraoperative complications were noted in 47 patients with stapled anastomosis.
- Postoperative complications for stapled anastomosis included wound infection, delayed gastric emptying, and ileus; no anastomotic dilatation occurred.
- Stapled anastomosis was associated with significantly shorter surgery times in cases of colostomy takedown with caliber discrepancy.
Conclusions:
- Stapled intestinal anastomosis is a safe and effective surgical option for various pediatric conditions.
- The technique demonstrates favorable outcomes in neonates, infants, and children, supporting its wider application.
Purpose:
Popularity of minimally invasive surgeries has led to the development of stapled intestinal anastomosis for adults. The advanced instruments used in this technique are getting suitable with the small intestinal lumens of neonates and infants. We reviewed and compared the intraoperative and postoperative results of stapled and hand-sewn anastomoses in children.
Methods:
The operative data of children who underwent stapled and hand-sewn anastomoses between March 2005 and December 2011 were collected and analyzed retrospectively. Furthermore, we compared patients who underwent anastomoses for colostomy closure of anorectal malformation (4 stapled, 9 hand-sewn) and those who underwent anastomoses for treatment of ileal atresia (3 stapled, 11 hand-sewn).
Results:
In the 47 patients who underwent stapled anastomosis, no intraoperative complications were observed and postoperative complications included wound infection (n = 3), delayed gastric emptying (n = 1), and ileus (n = 1). No complications suggesting anastomotic dilatation were identified. It was observed that patients who underwent stapled anastomosis for colostomy takedown with caliber discrepancy had significantly shorter surgery time than those who underwent hand-sewn anastomosis.
Conclusion:
Our results suggest that stapled anastomosis is safe and effective for various surgical diseases in neonates, infants, and children.
