Experience performing 64 consecutive stapled intestinal anastomoses in small children and infants.
OBJECTIVE
Intestinal anastomosis in children has traditionally been performed using hand-sewn techniques. Little data exist evaluating the efficacy of stapled intestinal anastomoses in the infant and pediatric populations.


METHODS
A review of a 5-year experience using a mechanical stapler to treat 64 consecutive children requiring intestinal anastomoses was performed. An intestinal stapler was used to complete a side-to-side functional end-to-end anastomosis. Postoperative outcomes and modifications made to the technique were identified.


RESULTS
Since 2004, 64 children (median age, 3 months; range, newborn to 24 months) underwent procedures requiring intestinal anastomosis. Twenty-six children (41%) were 1 week or less in age. Twenty-seven children (42%) underwent a stoma closure using a stapler. Thirty-seven children (58%) underwent bowel resection and stapled anastomosis in treating a variety of surgical disorders. Complications included wound infection (n = 2) and anastomotic stricture (n = 1). No issues suggesting anastomotic dilatation and subsequent stasis/overgrowth were identified.


CONCLUSIONS
These results suggest that stapled bowel anastomosis is an effective approach applicable to a variety of surgical diseases in newborns and infants.
Department of Pediatric Surgery, Children's Medical Center of Dallas, University of Texas Southwestern Medical Center, Dallas, TX 75235, USA.
Ian C S
IC
Mitchell
Robert
R
Barber
Anne C
AC
Fischer
David T
DT
Schindel
D000367:Age Factors; D000714:Anastomosis, Surgical / Q000295:instrumentation / Q000379:methods*; D002675:Child, Preschool; D003251:Constriction, Pathologic / Q000209:etiology / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007422:Intestines / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D017792:Surgical Stapling / Q000295:instrumentation / Q000379:methods*; D013536:Suture Techniques; D016896:Treatment Outcome