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Comparison of the two intestinal anastomosis methods in pediatric patients
Defeng Zeng1,2, Bingshan Xia1,2, Qianyang Liu1,2
1Department of Pediatric Surgery, Women and Children's Hospital, Chongqing Medical University, Chongqing, 401147, P. R. China.
Insights
Continuous single-layer (CSL) intestinal anastomosis is a safe and effective technique for pediatric patients, showing reduced anastomotic time and lower postoperative inflammation compared to interrupted double-layer (IDL) anastomosis.
Area of Science:
- Pediatric surgery
- Gastrointestinal surgery
- Surgical techniques
Background:
- Controversy exists regarding optimal gastrointestinal anastomosis techniques in pediatric patients.
- Comparison between continuous single-layer (CSL) and interrupted double-layer (IDL) anastomosis is needed.
Purpose of the Study:
- To evaluate the continuous single-layer (CSL) intestinal anastomosis method.
- To compare CSL with interrupted double-layer (IDL) anastomosis in pediatric patients.
Main Methods:
- Retrospective review of medical records for pediatric patients undergoing CSL (n=252) or IDL (n=196) anastomosis.
- Evaluation of perioperative outcomes: postoperative complications, anastomotic leakage, hospitalization cost, and postoperative hospital stay.
Main Results:
- No significant differences in anastomotic leakage or postoperative complications between CSL and IDL groups.
- CSL anastomosis demonstrated significantly shorter anastomotic time (11.6 vs 24.3 min, p < 0.001) and operative time (111.6 vs 124.1 min, p = 0.041).
- CSL group showed reduced C-reactive protein levels on postoperative day 5 (10.6 vs 12.8 mg/L, p = 0.032).
Conclusions:
- CSL anastomosis offers favorable clinical outcomes in pediatric patients.
- Benefits include reduced anastomotic time, shorter postoperative recovery, and decreased costs.
- CSL is a viable and potentially superior alternative for pediatric gastrointestinal reconstruction.
Background:
For pediatric patients, there is still controversy regarding the anastomotic technique used for gastrointestinal construction. The study was to evaluate the continuous single-layer (CSL) intestinal anastomosis method compared with the two-layered interrupted anastomosis.
Methods:
We retrospectively reviewed the medical records of the eligible patients following CSL anastomosis (n = 252) and interrupted double-layer (IDL) anastomosis (n = 196). The influences of CSL or IDL anastomosis on perioperative outcomes, including postoperative complications, anastomotic leakage, hospitalization cost, and postoperative hospital stay, were evaluated.
Results:
No significant differences were found between the CSL and IDL groups in terms of anastomotic leakage or postoperative complications. CSL anastomosis was related to favorable clinical outcomes, including anastomotic time (11.6 ± 3.8 vs 24.3 ± 5.9 min, p < 0.001) and operative time (111.6 ± 48.6 vs 124.1 ± 54.2 min, p = 0.041). There was a decrease in inflammation variable (e.g., C-reactive protein) on postoperative day 5 (10.6 ± 5.8 vs 12.8 ± 6.6 mg/L, p = 0.032) in patients with CSL anastomoses compared to the IDL group.
Conclusions:
The beneficial effects of CSL anastomosis in pediatric patients were demonstrated with respect to anastomotic time, length of postoperative recovery, and cost incurred.
