The extramucosal interrupted end-to-end intestinal anastomosis in infants and children; a single surgeon 21 year experience
The extramucosal interrupted end-to-end intestinal anastomosis in infants and children; a single surgeon 21 year experience
BACKGROUND/PURPOSE: To report outcomes of a standardised technique for intestinal anastomosis in infants and children.
METHODS: Data were prospectively collected on all paediatric intestinal anastomosis by a single surgeon over a 21year period. Anastomoses were constructed using an end-to-end extramucosal technique with interrupted polypropylene sutures. Demographic and clinical data were recorded.
RESULTS: Six-hundred and thirteen anastomoses were constructed in 550 patients. Median age at time of anastomosis was 6months (range 1day-226months). The most common reason for anastomosis was stoma closure (n=271, 49%). For those patients that required multiple anastomoses the most common pathology was acute NEC (n=22/41, 54%). One-hundred and one (18.4%) patients passed stool within 24hours of surgery, 175 (31.8%) between 24-48 hours and 95 (17.3%) between 48-72 hours. Anastomotic complications occurred in 7 patients (1.3%) including anastomotic leakage (n=5, 0.9%) and anastomotic stricture (n=2, 0.4%). The majority of anastomotic leakages (80%) followed resection of acute NEC.
CONCLUSIONS: The interrupted extramucosal anastomosis is safe and effective. The return of bowel function is rapid and the complication rate acceptable. We recommend this technique be used for all intestinal anastomoses in children and infants.
paediatric surgery, anastomsis, technique, necrotising enterocolitis, inflammatory bowel disease
1-4
Ross, Andrew R.
84f7078f-8f5f-43a0-828a-7d791fcbdf52
Hall, Nigel J.
6919e8af-3890-42c1-98a7-c110791957cf
Ahmed, S.A.
6aa77337-aa62-40d5-b3f7-0d64f1d1a1db
Kiely, Edward M.
40af8c7d-a7f7-4017-bc6e-39f53ee90508
Ross, Andrew R.
84f7078f-8f5f-43a0-828a-7d791fcbdf52
Hall, Nigel J.
6919e8af-3890-42c1-98a7-c110791957cf
Ahmed, S.A.
6aa77337-aa62-40d5-b3f7-0d64f1d1a1db
Kiely, Edward M.
40af8c7d-a7f7-4017-bc6e-39f53ee90508
Ross, Andrew R., Hall, Nigel J., Ahmed, S.A. and Kiely, Edward M.
(2015)
The extramucosal interrupted end-to-end intestinal anastomosis in infants and children; a single surgeon 21 year experience.
Journal of Pediatric Surgery, .
(doi:10.1016/j.jpedsurg.2015.11.018).
(PMID:26743344)
Abstract
BACKGROUND/PURPOSE: To report outcomes of a standardised technique for intestinal anastomosis in infants and children.
METHODS: Data were prospectively collected on all paediatric intestinal anastomosis by a single surgeon over a 21year period. Anastomoses were constructed using an end-to-end extramucosal technique with interrupted polypropylene sutures. Demographic and clinical data were recorded.
RESULTS: Six-hundred and thirteen anastomoses were constructed in 550 patients. Median age at time of anastomosis was 6months (range 1day-226months). The most common reason for anastomosis was stoma closure (n=271, 49%). For those patients that required multiple anastomoses the most common pathology was acute NEC (n=22/41, 54%). One-hundred and one (18.4%) patients passed stool within 24hours of surgery, 175 (31.8%) between 24-48 hours and 95 (17.3%) between 48-72 hours. Anastomotic complications occurred in 7 patients (1.3%) including anastomotic leakage (n=5, 0.9%) and anastomotic stricture (n=2, 0.4%). The majority of anastomotic leakages (80%) followed resection of acute NEC.
CONCLUSIONS: The interrupted extramucosal anastomosis is safe and effective. The return of bowel function is rapid and the complication rate acceptable. We recommend this technique be used for all intestinal anastomoses in children and infants.
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Accepted/In Press date: 21 November 2015
e-pub ahead of print date: 2 December 2015
Keywords:
paediatric surgery, anastomsis, technique, necrotising enterocolitis, inflammatory bowel disease
Organisations:
Human Development & Health
Identifiers
Local EPrints ID: 388579
URI: http://eprints.soton.ac.uk/id/eprint/388579
ISSN: 0022-3468
PURE UUID: 94991743-bcfe-46ff-9b5a-fa09ffc63986
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Date deposited: 01 Mar 2016 08:55
Last modified: 15 Mar 2024 03:38
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Author:
Andrew R. Ross
Author:
S.A. Ahmed
Author:
Edward M. Kiely
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