title: [Using Kehr's tube in complex anastomoses].
abstract: OBJECTIVE
  To present a new technique using the Kehr's T tube (KT) in complex intestinal anastomoses.
  
  
  METHODS
  Restrospective descriptive analysis of 8 patients intervened from 2007 to 2011. We performed intestinal anastomoses guided by a KT in 7 patients with intestinal atresia (yeyunal n = 5, ileal n = 1, duodenal n = 1), and in 1 patient with yeyunal stenosis associated with gastroschisis. 4 cases (50%) were reoperations because of complications after the first surgery.
  
  
  METHODS
  the KT is introduced through the dilated proximal bowel. The proximal end of the "T" is tied and the distal one acts as a transanastomotic guide and feeding tube. The long end of the T is externalized through the skin and used for the administration of the enteral nutrition formula. Studied variables were: beginning of enteral feeding, feeding time through the KT, time of intestinal motility recovery, time to complete oral feeding and complications.
  
  
  RESULTS
  There were no complications derived from the technique. Feeding was started through the KT between day 2 and 10 (median: 4.5), with a period of 4 to 33 days (median: 7). Patients started intestinal transit between days 2 and 7 (median: 3.5). Reoperated patients showed cholestasis and/or sepsis signs, which were solved with surgery. The KT was left in place between 11-51 days (median: 22), with no complications during or after the removal.
  
  
  CONCLUSIONS
  The results of this preliminary study suggests that the use of the KT in complex anastomoses as a transanastomotic guide and feeding tube presents advantages, such as early enteral feeding and prevention of leakage and kinking of the intestinal suture. There were no complications derived from the procedure. As far as we know, this technique has not been previously reported in the literature.
authors.affiliation: Servicio de Cirugía Pediátrica, Hospital Universitario La Fe, Valencia. tania_mj21@hotmail.com
authors.forename: Jareño T
authors.initials: JT
authors.lastname: Moratalla
authors.forename: C Gutiérrez
authors.initials: CG
authors.lastname: San Román
authors.forename: A
authors.initials: A
authors.lastname: Domenèch Tárrega
authors.forename: L
authors.initials: L
authors.lastname: Mangas Alvarez
authors.forename: M F
authors.initials: MF
authors.lastname: Bordallo Vázquez
authors.forename: J Gómez-Chacón
authors.initials: JG
authors.lastname: Villalba
authors.forename: C
authors.initials: C
authors.lastname: García-Sala
mesh_terms: D000714:Anastomosis, Surgical / Q000295:instrumentation; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007409:Intestinal Atresia / Q000601:surgery*; D007422:Intestines / Q000601:surgery*; D007440:Intubation / Q000295:instrumentation*; D008297:Male; D012189:Retrospective Studies