Stapled intestinal anastomoses in infants.
BACKGROUND
We reviewed our experience with stapled intestinal anastomoses in infants younger than 1 year and compared operative data and outcome to that of infants who underwent hand-sewn anastomoses.


METHODS
Infants younger than 1 year who underwent an intestinal anastomosis over an 8-year period were identified. Stapled anastomoses were constructed in a side-to-side fashion using standard or endoscopic linear cutters. Outcome variables including operative time, anastomotic failure, and death were recorded.


RESULTS
Two hundred ninety-five subjects were identified. Hand-sewn anastomoses were performed in 189 cases and stapled anastomoses in 106. Patients who had a stapled anastomosis were older (105 vs 44 days) and larger (5.2 vs 3.1 kg), although 25 stapled anastomoses were performed in infants between 600 and 1000 g. When a stapled anastomosis was used operative time was significantly reduced overall (102 vs 128 minutes) and for individual procedures including resection for necrotizing enterocolitis (85 vs 132 minutes) and colostomy closure (104 vs 141 minutes). There was no difference between hand-sewn and stapled anastomoses in the incidence of adhesive obstruction, stricture, or leak.


CONCLUSIONS
When permitted by intestinal size in infants younger than 1 year, stapled anastomoses were safe and effective and significantly reduced operative time.
Wrighton
Lindsay
L
Division of Pediatric Surgery, Loma Linda University School of Medicine and Children's Hospital, Loma Linda, CA 92354, USA.
Curtis
Jennifer L
JL
Gollin
Gerald
G
D000367:Age Factors; D000714:Anastomosis, Surgical / Q000379:methods / Q000706:statistics & numerical data; D001835:Body Weight; D003106:Colon / Q000601:surgery*; D004065:Digestive System Abnormalities / Q000601:surgery; D020345:Enterocolitis, Necrotizing / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000601:surgery; D007410:Intestinal Diseases / Q000601:surgery*; D007421:Intestine, Small / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D017792:Surgical Stapling / Q000706:statistics & numerical data; D013536:Suture Techniques / Q000706:statistics & numerical data