Stapled intestinal anastomosis in neonates and infants: Use of the endoscopic intestinal stapler

Stapled anastomoses of the gastrointestinal tract, commonplace in adults and older children, are rarely performed in newborns because of the size of the instruments. The development of smaller stapling devices for laparoscopic and thoracoscopic procedures presented an opportunity to evaluate the eff...

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Bibliographic Details
Published in:Journal of pediatric surgery 1995-02, Vol.30 (2), p.195-197
Main Author: Powell, Randall W
Format: Article
Language:English
Subjects:
Age Factors
Biological and medical sciences
Endoscopes, Gastrointestinal
Female
Gastroenterostomy - adverse effects
Gastroenterostomy - instrumentation
Gastrointestinal Hemorrhage - prevention & control
Humans
Infant
Infant, Newborn
Intestines - surgery
Male
Medical sciences
Stomach, duodenum, intestine, rectum, anus
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the digestive system
Surgical Staplers
Surgical Stapling - adverse effects
Surgical Stapling - instrumentation
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Summary:Stapled anastomoses of the gastrointestinal tract, commonplace in adults and older children, are rarely performed in newborns because of the size of the instruments. The development of smaller stapling devices for laparoscopic and thoracoscopic procedures presented an opportunity to evaluate the efficacy of such anastomoses in neonates and infants. Over an 11-month period, seven newborn or young infants underwent stapled functional end-to-end small or large intestinal anastomoses using the Endo-GIA 30. The male:female ratio was 3:4, and the mean age was 72d (range, 1 to 134 days). The mean weight at the time of the stapled anastomosis was 3.7 kg (range, 1.88 to 6.6 kg). The clinical setting requiring the intestinal anastomoses included ileostomy closure after perforated necrotizing enterocolitis (3), intestinal atresia (1), distal ileal volvulus (1), left colon mesenteric cyst (1), and biliary atresia (1). There were no deaths or anastomotic leaks. Nasogastric decompression was discontinued at a mean of 6 days (range, 3 to 11 days), and oral feedings were begun at a mean of 7.0 days (range, 4 to 12 days). The patients were discharged from the hospital 7 to 117 days after the operation (mean, 33 days). The endoscopic stapling instrument is safe and effective in performing small and large intestinal anastomoses in newborns and young infants.
ISSN:0022-3468
1531-5037
DOI:10.1016/0022-3468(95)90559-6