Complications of mechanical suturing in pediatric patients.
OBJECTIVE
Although it is widely accepted that staplers are effective in reducing operating time, potential complications related to their use in the pediatric population are not well defined yet. The aim of this study is to evaluate the safety of mechanical suturing.


METHODS
Between 1996 and 2001, 174 procedures were performed using circular staplers in gastrointestinal anastomosis, whereas linear staplers were used in gastrointestinal and lung resection. Intraoperative and early complications of each intervention were recorded.


RESULTS
Overall, 12 complications occurred (6.9%). Two were caused by technical problems: In one case the stapler broke, in the other the anvil detached from the instrument shaft. Ten (5.7%) were major complications: 2 cases of leakage and 3 of bleeding in gastrointestinal procedures, and one case of bronchopleural fistula and 4 cases of bleeding during lung surgery. There was a significant correlation (P <.05) between type of stapler used and development of complications, suggesting a safer use of endoscopic staplers compared with conventional linear ones.


CONCLUSIONS
Mechanical suturing in children is not used frequently, but some procedures could be used more widely because they are fast and safe.
Mattioli
Girolamo
G
Department of Pediatric Surgery, Giannina Gaslini Research Institute, University of Genova, Genova, Italy.
Castagnetti
Marco
M
Repetto
Paolo
P
Leggio
Samuele
S
Jasonni
Vincenzo
V
D000293:Adolescent; D000714:Anastomosis, Surgical / Q000379:methods; D002648:Child; D002675:Child, Preschool; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004868:Equipment Failure; D005260:Female; D006801:Humans; D007223:Infant; D007431:Intraoperative Complications; D008297:Male; D011013:Pneumonectomy / Q000379:methods*; D011183:Postoperative Complications; D017792:Surgical Stapling / Q000009:adverse effects*