Intestinal anastomosis in children: a comparative study between two different techniques.
OBJECTIVE
The aim of this study was to compare the incidence of surgical complications between two different surgical techniques for intestinal anastomosis in children.


METHODS
This was a clinically controlled, randomized study with blind follow-up from 18 to 36 months performed at the Reference Government Hospital in Mexico City. Eighty-six children required intestinal anastomosis, ages ranged between 1 month and 16 years, with emergency or elective surgery. Anastomoses of duodenum, rectum, with enteroplasty or protected with a proximal stoma were excluded. Two randomized groups were formed: (1) anastomosis with one layer of suture (Gambee stitches) and (2) with two layers of suture (first with Connel-Mayo stitches then with Lembert). Both groups were controlled in the principal variables without differences, and the follow-up concerning postoperative recovery was blind for the surgical team.


RESULTS
Forty-two cases in group 1 and 44 in group 2 were compared. Intestinal dehiscence was found in 5 of 86 (5.8%), two from group I and three from group II (P value, not significant). Surgical time for anastomosis with one layer was an average of 26 minutes versus 43 minutes with two layers (P<.001). There were no stenoses within the follow-up period.


CONCLUSIONS
This study proves that intestinal anastomosis with one layer of suture is as safe as anastomosis with two layers in children, and the time spent for completion of the procedure is significantly less with one plane of suture. For those reasons, it is the method of choice for intestinal anastomosis in children.
Ordorica-Flores
R M
RM
Department of Pediatric Surgery, Hospital Infantil de Mexico Federico Gómez, Universidad Nacional Autónoma de México, México City.
Bracho-Blanchet
E
E
Nieto-Zermeño
J
J
Reyes-Retana
R
R
Tovilla-Mercado
J M
JM
Leon-Villanueva
V
V
Varela-Fascinetto
G
G
D000293:Adolescent; D000714:Anastomosis, Surgical / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007421:Intestine, Small / Q000601:surgery*; D013529:Surgical Wound Dehiscence; D013536:Suture Techniques