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Updated: Mar 27, 2026
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
The extramucosal interrupted end-to-end intestinal anastomosis in infants and children; a single surgeon 21year
Andrew R Ross1, Nigel J Hall1, S A Ahmed1
1Great Ormond Street Hospital, London UK.
Insights
A standardized extramucosal intestinal anastomosis technique using interrupted sutures is safe and effective in infants and children. This method ensures rapid return of bowel function and an acceptable complication rate for pediatric patients.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
- Surgical Techniques
Background:
- Intestinal anastomosis is a critical procedure in pediatric surgery.
- Standardized techniques are essential for optimizing outcomes in infants and children.
Purpose of the Study:
- To evaluate the outcomes of a standardized extramucosal intestinal anastomosis technique.
- To assess the safety and efficacy of this technique in pediatric patients.
Main Methods:
- Prospective data collection over 21 years for pediatric intestinal anastomoses.
- End-to-end extramucosal technique with interrupted polypropylene sutures.
- Inclusion of demographic and clinical data for 550 patients.
Main Results:
- 613 anastomoses performed, with stoma closure being the most common indication.
- Rapid return of bowel function observed: 18.4% within 24 hours, 31.8% within 24-48 hours.
- Low complication rate: 1.3% overall, including 0.9% anastomotic leakage and 0.4% stricture, particularly after NEC resection.
Conclusions:
- The interrupted extramucosal anastomosis is a safe and effective surgical method.
- The technique facilitates a quick recovery of bowel function in pediatric patients.
- Recommended for all infant and child intestinal anastomoses due to acceptable complication rates.
Background/Purpose:
To report outcomes of a standardised technique for intestinal anastomosis in infants and children.
Methods:
Data were prospectively collected on all paediatric intestinal anastomosis by a single surgeon over a 21year period. Anastomoses were constructed using an end-to-end extramucosal technique with interrupted polypropylene sutures. Demographic and clinical data were recorded.
Results:
Six-hundred and thirteen anastomoses were constructed in 550 patients. Median age at time of anastomosis was 6months (range 1day-226months). The most common reason for anastomosis was stoma closure (n=271, 49%). For those patients that required multiple anastomoses the most common pathology was acute NEC (n=22/41, 54%). One-hundred and one (18.4%) patients passed stool within 24hours of surgery, 175 (31.8%) between 24-48 hours and 95 (17.3%) between 48-72 hours. Anastomotic complications occurred in 7 patients (1.3%) including anastomotic leakage (n=5, 0.9%) and anastomotic stricture (n=2, 0.4%). The majority of anastomotic leakages (80%) followed resection of acute NEC.
Conclusions:
The interrupted extramucosal anastomosis is safe and effective. The return of bowel function is rapid and the complication rate acceptable. We recommend this technique be used for all intestinal anastomoses in children and infants.
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