Stapled versus hand-sewn pediatric intestinal anastomoses: A retrospective cohort study

Area of Science:

• Pediatric Surgery
• Gastrointestinal Surgery
• Surgical Innovation

Background:

• The safety of stapled anastomoses is well-established in adults but less studied in pediatric populations.
• The choice between hand-sewn (HS) and stapled anastomosis (SA) in children requires further investigation.
• This study addresses the limited research on pediatric intestinal anastomosis techniques.

Purpose of the Study:

• To compare the anastomotic outcomes of hand-sewn versus stapled techniques in children under five years of age.
• To evaluate complications such as anastomotic leak and stricture in pediatric patients.

Main Methods:

• Retrospective analysis of 72 patients with 90 intestinal anastomoses (2012-2016).
• Comparison of demographics, diagnosis, anatomy, and complications between HS and SA groups.
• Primary outcomes: anastomotic leak and/or stricture requiring intervention. Level of Evidence: 3 (Retrospective Comparative Treatment Study).

Main Results:

• No statistically significant differences in primary outcomes (anastomotic leak/stricture) between HS and SA groups.
• Overall complication rates were 23.9% for HS and 17.4% for SA.
• In the ileocolic subgroup, HS had 3 complications vs. 0 for SA (not significant). All SA complications involved 3.5 or 3.8mm staples.

Conclusions:

• No statistically significant difference was found between hand-sewn and stapled intestinal anastomosis outcomes in this pediatric study population.
• The findings suggest comparable safety profiles for both techniques in young children.
• Further investigation is warranted to solidify these conclusions and guide clinical practice.