Background . Incorporation of a poly-ε-caprolactone (PCL) scaffold in circular stapled anastomoses has been shown to increase the anastomotic tensile strength on postoperative day (POD) 5 in a pig model. The aim of this study was to investigate the effects of incorporation of a PCL scaffold in a circular stapled end-to-end small intestine anastomosis, with stricture formation and anastomotic histology as primary outcomes in a 30-day observation period. Methods . A total of 15 piglets were included. In each piglet, three circular stapled end-to-end anastomoses were made in the small intestines. Two were interventional and one was a control. On POD 10, 20, or 30, the anastomoses were subjected to in vivo intraluminal contrast study, and the index for anastomotic lumen was calculated. The anastomotic segment was resected and subjected to a tensile strength test and histological examination. Results . At POD 10, the mean ± SD value for anastomotic index was .749 ± .065 in control anastomoses and .637 ± .051 in interventional anastomosis ( P = .0046), at POD 20, .541 ± .150 and .724 ± .07 ( P = .051), and at POD 30, .645 ± .103 and .686 ± .057 ( P = .341), respectively. No significant difference was observed in maximum tensile strength and histology at POD 30. Conclusions . The incorporation of a PCL scaffold in a circular stapled end-to-end small intestine anastomosis does not increase the risk of stricture or impair wound healing after 30 days.
Background There is no consensus on the use of perioperative antibiotic in full-thickness rectal biopsies (FTB) in children suspected for Hirschsprung disease. The primary objective of this study was to examine the effect of perioperative antibiotics on infectious and overall complications rate in FTB performed in children under the age of 1 year. Methods A retrospective chart review. Two time periods were compared—one with and one without the routine use of perioperative antibiotics. The treatment included cefuroxime 100 mg/kg and metronidazole 20 mg/kg administered intravenously at anesthesia induction followed by peroral administration of amoxicillin 50 mg/kg with Clavulanic acid 12.5 mg/kg three times a day t.i.d. for 3 days postoperative. Results In the group with perioperative antibiotics the infectious complications rate was 3.3% compared to 13.4% in the group without (p = 0.03) with fever as the most common. The overall complication rate was 11.3% and 15.2%, respectively (p = 0.43). Conclusion Perioperative antibiotics significantly reduced the rate of infectious complications, but not the rate of overall complication rate after a full thickness rectal biopsy in children under the age of 1 year.
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