Comparison of stapler and hand-sewn roux en Y jejunal anastomosis in children

Year 2022, Volume: 47 Issue: 4, 1424 - 1430, 28.12.2022

Murat Alkan Kamuran Tutuş Selcan Türker Çolak Ender Fakıoğlu Şeref Selçuk Kılıç Onder Ozden Recep Tuncer

https://doi.org/10.17826/cumj.1091286

Abstract

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.

Keywords

Roux en Y, Anastomosis, Stapler, Children

Çocuklarda roux en Y jejunal anastomozda stapler kullanımı ile elle anastomozun karşılaştırılması

Abstract

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.

Keywords

Roux en Y, Anastomoz, Stapler, Çocuklar

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