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Stapled intestinal anastomosis is a simple and reliable method for management of intestinal caliber discrepancy in children
Authors:Kaori Sato  Hiroo Uchida  Yujiro Tanaka  Shinya Takazawa  Takahiro Jimbo  Kyoichi Deie
Institution:Department of Pediatric Surgery, Saitama Children's Medical Center, 2100 Magome, Iwatsuki, Saitama, Saitama, 339-8551, Japan.
Abstract:

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.
Keywords:
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