Stapled Intestinal Anastomoses with Endoscopic Staplers In Premature Infants

This is Todd Ponsky with the Journal of Pediatric Surgery, and here's your two-minute review. Today we're going to review a paper called Stapled Intestinal Anastomosis with Endoscopic Stapler in Premature infants. The first author is Doctor Muncy, and the senior author is Doctor Chris Blewett. So this paper talks about should we be doing stapled anastomosis in tiny babies. Forever we've all been taught in small children, in small preemies, we do hand sewn anastomosis, mostly because the stapler really didn't quite fit into the bottle. But this group checked to see how does staple compare to hand sewn. In the adult population, there's no difference. So what they did is a retrospective review. Patients were excluded if they were greater than 36 weeks of gestational age or greater than 5 kg. The two groups were essentially equivalent. The Hanson group had 33 patients and the staple group had 38 patients. When they looked at the results between the two groups, they found no difference. They looked at anastomotic leak, anastomotic stricture, and blood per rectum following the anastomosis. There was no difference in any of these three measurements. Of note though, the two different patient populations were actually different. The pathology, the age of the patient, and the demographics were not exactly equal in the two groups. I thought this was an interesting paper, as a lot of us are recently discussed. The idea of doing stapled anastomosis in babies since the development of these new 5 millimeter stapling devices. I do get concerned about putting in a traditional large stapler into premature baby bowel. However, with the 5 millimeter staplers, I think this study gives us some confidence that this might be a reasonable approach. We hope you enjoyed the review. We'll see you next time.