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A Cochrane review including seven RCTs with 1125 patients reported that SA had a significantly lower incidence of anastomotic leakage than had HA. The safety and efficacy of SA in adults has been widely reported. Moreover, the operative time was significantly shorter in the SA group than in the HA group in this population. The results of this meta-analysis showed that SA was comparable to HA in the overall rate of anastomotic leakage, anastomotic stricture, ileus, and anastomosis related complications in children aged < 1 year. References Author name and year of publicationĪnorectal malformation with colostomy closure
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Monofilament or braided, absorbable suture material (PDS or Vicryl)Įndocutter ETS 35, ETS Flex 45 stapler, and the Echelon Flex Powered ENDOPATH Stapler with 2.5- or 3.5-mm staples (Johnson & Johnson K.K., Tokyo, Japan) Proximate, ETS (Ethicon,Somerville, NJ), DST GIA ,and Endo GIA (Covidien New Haven, CT) Monofilament or braided, absorbable suture materialĮndopath ATW-35 Endoscopic Articulating Linear Stapler with 2.5-mm staples (Ethicon Endo-Surgery, Cincinnati, OH, USA)ģ0 mm × 2.5 mm endoscopic staplers (Covidien, Mansfield, MA) Therefore, the aim of this study was to perform a meta-analysis to evaluate the safety and effectiveness of SA compared with HA in pediatric patients.Įndo-GIA or GIA linear cutter with 2.5-mm staples (Ethicon Endo-Surgery, Cincinnati, OH, USA) However, the number of cases in these studies was small, and the effectiveness of SA has not yet been confirmed. These studies reported that SA had the same frequency of complications as HA had, and SA had a shorter operative time, an earlier time until initial feeding, and a shorter length of hospital stay than had HA. Since Powell reported the usefulness of SA in infants younger than 5 months in 1995, reports of SA in pediatric patients have gradually increased. Traditionally, end-to-end HA has been widely used for pediatric patients. This is probably due to less inflammation of the anastomotic site, decreased spillage of bowel content during surgery, and a uniform method of anastomosis using a stapler. A Cochrane review reported that fewer anastomotic leakages are observed with SA than with hand-sewn anastomosis (HA). In adults, stapled anastomosis (SA) is widely used for intestinal anastomosis. A safe and an effective intestinal anastomotic procedure that does not cause complications, including anastomotic leakage, anastomotic stricture, and intestinal obstruction, is required for the rapid recovery of patients.
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In pediatric surgery, intestinal anastomosis is performed in patients of various ages, conditions, and etiologies such as necrotizing enterocolitis or duodenal atresia (in infants) and Crohn’s disease or malignant lymphoma (in adolescents). The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.