Neonatal Intestinal Anastomosis Using a 5 mm Laparoscopic Stapler

Walk, Casey T; Meagher, David P.; Christian, J. D.; Barnett, Sean; Pence, Jeffrey C.; Chaudhary, Mirnal; Aranda, Arturo

doi:10.1089/lap.2018.0524

Cited by 8 publications

(3 citation statements)

References 3 publications

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“…Although there is a limit on the size of the intestinal lumen into which the stapling device can be safely inserted, SA could be acceptable even in small children. Recently, the feasibility and safety of a 5-mm stapler in small children have been reported [ 18 , 19 ]. Although the 5-mm stapler was not used in this study, such miniature devices may offer an alternative to HA in the smaller intestinal lumen.…”

Section: Discussionmentioning

confidence: 99%

Stapled versus hand-sewn intestinal anastomosis in pediatric patients: a systematic review and meta-analysis

et al. 2021

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Background The safety and feasibility of stapled intestinal anastomosis have been widely reported in adults. However, the efficacy of stapled anastomosis (SA) in children is unclear. The aim of this study was to perform a systematic review and meta-analysis to evaluate the safety and effectiveness of SA compared with hand-sewn anastomosis (HA) in pediatric patients. Methods A systematic literature search was performed using PubMed, the Cochrane Library, and Scopus databases. Studies comparing outcomes of children aged < 7 years and subgroups of children aged < 1 year who underwent SA or HA were included. Primary outcomes were anastomotic leakage and anastomotic stricture. Mean differences (MDs) with 95 % confidence intervals (CIs) were calculated for continuous variables. Odds ratios (ORs) with 95 % CIs were calculated for dichotomous variables. Interstudy heterogeneity was assessed using the chi-squared test and was quantified using the I² statistic. Results One randomized control trial and five retrospective cohort studies, comprising 633 cases (229 SA cases and 404 HA cases), were included. No significant differences were observed in anastomotic leakage (6.5 % vs. 7.4 %; OR, 0.93; 95 % CI, 0.37–2.34; p = 0.88), anastomotic stricture (4.1 % vs. 9.3 %; OR, 0.54; 95 % CI, 0.19–1.51; p = 0.24), ileus (7.1 % vs. 9.3 %, OR, 2.35; 95 % CI, 0.15–37.51; p = 0.54), anastomosis-related complications (9.5 % vs. 10.9 %, OR, 0.98; 95 % CI, 0.52–1.86; p = 0.96; I2 = 39 %), and time until full-feeding (MD = -3.57 days; 95 % CI, -11.36 to 4.23; p = 0.37) between SA and HA. Operative time was significantly shorter in SA than in HA in children aged < 1 year (MD = -20.36 min; 95 % CI, -26.13 to -14.59). Conclusions SA required shorter operative time and was comparable to HA in the overall complication rate. Although the evidence was insufficient, SA could be an option for intestinal anastomosis in children.

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Section: Discussionmentioning

confidence: 99%

Stapled versus hand-sewn intestinal anastomosis in pediatric patients: a systematic review and meta-analysis

et al. 2021

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“…«Стент» обеспечивал декомпрессию проксимальной кишки и позволил избежать резекции расширенного сегмента, тем самым сохранив длину кишечника [59]. Относительно новым и перспективным в лечении пациентов с атрезией тощей и подвздошной кишки представляется использование степлера для соединения разобщенных сегментов кишечника [60].…”

Section: способы и методики хирургического лечения атрезии тонкой кишкиunclassified

Surgical treatment of newborns with small bowel atresia (literature review)

Batchenko¹,

Mokrushina²,

Gogichaeva³

2020

Russian Journal of Pediatric Surgery, Anesthesia and Intensive

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Intestinal atresia is a congenital obstruction of the lumen of the jejunum or ileum and is one of the most common causes of congenital obstruction in newborns. This literature review is devoted to the surgical treatment of newborns with various types intestinal atresia. Causes of intestinal atresia are considered, where a special role is assigned to the genetic theory, the expression of the nucleotide sequences ITGA2 873G/A and NPPA 2238T/C and antenatal circulatory disorders of the developing intestine. Topographical-anatomical and morphological characteristics of the intestine in newborns with intestinal atresia are studied in detail in articles. A table of revealed histomorphological features of the small intestine in children with atresia was compiled. In addition, processes occurring in the mucosa, submucosa, muscle, and serous membranes are described in detail. A relationship was found related to the size of the atresia site and duration of ischemia. The theory of neuromuscular regulation of the intestine is considered, in which an important role is assigned to interstitial pacemaker cells of Cajal. Variants of anastomosis depending on the difference in diameters of the adductor and excretory parts of the intestine are analyzed, and results of treatment in patients with laparoscopic access are described. The postoperative course of disease, development of complications, recurrent operative interventions, duration of parenteral nutrition, and onset of enteral load was evaluated. Conclusion. The choice of surgical technologies used to restore the patency of the intestinal tube is determined by the degree of discrepancy between diameters of anastomosed segments. The prognosis is not determined by tactics of surgical treatment, type of atresia, time before treatment, and presence of associated anomalies.

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“…3 Thoracoscopic lung lobectomy, laparoscopic anorectoplasty, and laparoscopic intestinal anastomosis for intestinal atresia have been reported using these instruments. [4][5][6] However, no cases of laparoscopic Roux-Y reconstruction for a small infant using a 5-mm stapler have been reported.…”

Section: Introductionmentioning

confidence: 99%

Complete laparoscopic choledochal cyst excision and hepaticojejunostomy with laparoscopic Roux‐Y reconstruction using a 5‐mm stapler: A case of a 2‐month‐old infant

Murakami

Kaji

Nagano

et al. 2021

Asian J Endoscop Surgery

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Laparoscopic choledochal cyst excision and hepaticojejunostomy for choledochal in children is performed only at particular institutions because of the technical difficulty. Although choledochal cyst excision and hepaticojejunostomy are feasible, the small working space of infants makes intraabdominal Roux-Y reconstruction technically challenging. A 2-monthold girl diagnosed with a choledochal cyst underwent complete laparoscopic choledochal cyst excision and hepaticojejunostomy, including intraabdominal Roux-Y reconstruction with a 5-mm stapler. After cyst excision, Roux-Y reconstruction was performed in the intraabdominal cavity. Jejunojejunostomy was performed in a side-to-side fashion using a 5-mm stapler, and the entry hole was closed laparoscopically by hand-sewing, along with the mesentery defect. All procedures were performed by laparoscopic surgery. The postoperative course was uneventful, and the patient showed a quick recovery. Using small-diameter instruments, completely laparoscopic procedures for choledochal cyst are feasible.

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Neonatal Intestinal Anastomosis Using a 5 mm Laparoscopic Stapler

Cited by 8 publications

References 3 publications

Stapled versus hand-sewn intestinal anastomosis in pediatric patients: a systematic review and meta-analysis

Stapled versus hand-sewn intestinal anastomosis in pediatric patients: a systematic review and meta-analysis

Surgical treatment of newborns with small bowel atresia (literature review)

Complete laparoscopic choledochal cyst excision and hepaticojejunostomy with laparoscopic Roux‐Y reconstruction using a 5‐mm stapler: A case of a 2‐month‐old infant

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