Öz
outcomes of stapled and hand-sewn Roux-en-Y intestinal anastomoses in childhood.
Materials and Methods: At a university hospital, the records of the children who underwent roux-en-Y anastomosis between December 2007 and December 2014 were reviewed. The data were compared according to the roux-en-Y anastomosis technique used (stapled versus hand-sewn).
Results: A total of 52 patients had undergone roux-en-Y anastomosis. All had biliary atresia or choledochal cyst. Thirty-one of the patients were diagnosed with biliary atresia and 21 with choledochal cysts. Staple anastomosis technique was used in 16 of the patients with biliary atresia and 9 of the patients with choledochal cyst. Both in biliary atresia and choledochal cyst cases; operations with stapled anastomosis were significantly shorter than the ones with hand-sewn anastomosis. Among the biliary atresia cases, post-operative oral feeding was initiated significantly earlier in the stapled group, with its lower risks of post-operative cholangitis and longer hospital stay than 7 days.
Conclusion: This is the first study in children, confirming the time-saving advantage of stapled anastomosis over hand-sewn, during roux-en-Y anastomosis for biliary atresia and choledochal cyst; along with the safety of stapler use, including the neonates. Stapled anastomosis yields lower complication rates, faster function gain with earlier feeding and hospital discharge.
Anahtar Kelimeler
Kaynakça
- 1. Deitel M. Cesar Roux and his contribution. Obes Surg. 2007;17:1277-8.
- 2. Chassin JL, Rifkind KM, Sussman B, Kassel B, Fingaret A, Drager S, et al. The stapled gastrointestinal tract anastomosis: incidence of postoperative complications compared with the sutured anastomosis. Ann Surg. 1978;188:689-96.
- 3. Didolkar MS, Reed WP, Elias EG, Schnaper LA, Brown SD, Chaudhary SM. A prospective randomized study of sutured versus stapled bowel anastomoses in patients with cancer. Cancer. 1986;57:456-60.
- 4. Lovegrove RE, Constantinides VA, Heriot AG, Athanasiou T, Darzi A, Remzi FH, et al. A comparison of hand-sewn versus stapled ileal pouch anal anastomosis (IPAA) following proctocolectomy: a meta-analysis of 4183 patients. Ann Surg. 2006;244:18-26.
- 5. Catena F, La Donna M, Gagliardi S, Avanzolini A, Taffurelli M. Stapled versus hand-sewn anastomoses in emergency intestinal surgery: results of a prospective randomized study. Surg Today. 2004;34:123-6.
- 6. Steichen FM. The use of staplers in anatomical side-to-side and functional end-to-end enteroanastomoses. Surgery. 1968;64:948-53.
- 7. IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp.
- 8. Powell RW. Stapled intestinal anastomosis in neonates and infants: use of the endoscopic intestinal stapler. J Pediatr Surg. 1995;30:195-7.
- 9. Wrighton L, Curtis JL, Gollin G. Stapled intestinal anastomoses in infants. J Pediatr Surg. 2008;43:2231-4.
- 10. Simmons JD, Gunter JW, 3rd, Manley JD, Sawaya DE, Blewett CJ. Stapled intestinal anastomosis in neonates: validation of safety and efficacy. The American surgeon. 2010;76:644-6.
- 11. Kozlov Y, Novogilov V, Podkamenev A, Weber I. Stapled bowel anastomoses in newborn surgery. Eur J Pediatr Surg. 2013;23:63-6.
Öz
yapılan roux en Y bağırsak anastomozunun sonuçlarının karşılaştırılmasını amaçlamaktadır.
Gereç ve Yöntem: Bir üniversite hastanesinde Aralık 2007 ile Aralık 2014 tarihleri arasında roux-en-Y anastomozu yapılan çocukların kayıtları incelendi. Veriler anastomoz tekniğine göre sınıflandırılıp kıyaslandı.
Bulgular: Toplamda 52 hastaya roux en Y anastomozu uygulandı. Hastaların biliyer atrezi veya koledok kisti tanıları vardı. Hastaların 31’i biliyer atrezi, 21’i ise koledok kisti tanılı idi. Biliyer atrezili hastaların 16’sında, koledok kisti hastalarının 9’unda stapler anastomoz tekniği kullanıldı. Hem biliyer atrezi hem de koledok kisti olgularında stapler ile anastomoz yapılanların operasyon süreleri elle anastomoz yapılanlara göre anlamlı olarak daha kısaydı. Biliyer atrezili grupta stapler ile anastomozda oral beslenme anlamlı olarak daha erkendi). Ayrıca bu grupta postoperatif kolanjit ve 7 günden uzun hastanede kalış riski daha düşüktü.
Sonuç: Bu çalışma çocuklarda bilyer atrezi ve koledok kistinde roux en Y için stapler ile anastomozun elle anastomoza göre zaman kazandırma avantajını doğrulayan ilk çalışmadır. Yenidoğanlar da dahil olmak üzere stapler kullanımının güvenli olduğunu belirtmektedir. Stapler ile anastomoz daha düşük komplikasyon, daha erken beslenme ve daha az hastanede yatış üzerinde olumlu etki sağlamaktadır.
Kaynakça
- 1. Deitel M. Cesar Roux and his contribution. Obes Surg. 2007;17:1277-8.
- 2. Chassin JL, Rifkind KM, Sussman B, Kassel B, Fingaret A, Drager S, et al. The stapled gastrointestinal tract anastomosis: incidence of postoperative complications compared with the sutured anastomosis. Ann Surg. 1978;188:689-96.
- 3. Didolkar MS, Reed WP, Elias EG, Schnaper LA, Brown SD, Chaudhary SM. A prospective randomized study of sutured versus stapled bowel anastomoses in patients with cancer. Cancer. 1986;57:456-60.
- 4. Lovegrove RE, Constantinides VA, Heriot AG, Athanasiou T, Darzi A, Remzi FH, et al. A comparison of hand-sewn versus stapled ileal pouch anal anastomosis (IPAA) following proctocolectomy: a meta-analysis of 4183 patients. Ann Surg. 2006;244:18-26.
- 5. Catena F, La Donna M, Gagliardi S, Avanzolini A, Taffurelli M. Stapled versus hand-sewn anastomoses in emergency intestinal surgery: results of a prospective randomized study. Surg Today. 2004;34:123-6.
- 6. Steichen FM. The use of staplers in anatomical side-to-side and functional end-to-end enteroanastomoses. Surgery. 1968;64:948-53.
- 7. IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp.
- 8. Powell RW. Stapled intestinal anastomosis in neonates and infants: use of the endoscopic intestinal stapler. J Pediatr Surg. 1995;30:195-7.
- 9. Wrighton L, Curtis JL, Gollin G. Stapled intestinal anastomoses in infants. J Pediatr Surg. 2008;43:2231-4.
- 10. Simmons JD, Gunter JW, 3rd, Manley JD, Sawaya DE, Blewett CJ. Stapled intestinal anastomosis in neonates: validation of safety and efficacy. The American surgeon. 2010;76:644-6.
- 11. Kozlov Y, Novogilov V, Podkamenev A, Weber I. Stapled bowel anastomoses in newborn surgery. Eur J Pediatr Surg. 2013;23:63-6.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Araştırma |
| Yazarlar | |
| Yayımlanma Tarihi | 28 Aralık 2022 |
| Kabul Tarihi | 28 Ağustos 2022 |
| Yayımlandığı Sayı | Yıl 2022 Cilt: 47 Sayı: 4 |
