Neonatal Intestinal Anastomosis Using a 5 mm Laparoscopic Stapler
Neonatal Intestinal Anastomosis Using a 5 mm Laparoscopic Stapler
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DOI：
10.1089/lap.2018.0524
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发表时间：
2019-04-01
影响因子：
1.3
通讯作者：
Aranda, Arturo
中科院分区：
文献类型：
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作者：
Walk, Casey T.;Meagher, David;Aranda, Arturo
最近，一种5毫米腹腔镜订书机进入市场，目前广泛用于各种儿科应用。这篇文章的目的是首次报道使用这种5毫米腹腔镜吻合器在人类开放新生儿肠吻合术。我们在5例患者中使用justight (justight Surgical) 5mm腹腔镜吻合器(R)，共构建6个吻合器。这些诊断为闭合性胃裂合并回肠闭锁、多发性肠闭锁、回肠闭锁和空肠闭锁的新生儿在肠切除术后进行肠肠造口术。侧对侧、功能性端对端吻合术以标准的反肠方式进行。使用2.5 cm长的短钉载荷，吻合口约1.5 cm。发生最小的订书钉线重叠。分别于术后第8天和15.2天开始肠内喂养并达到营养目标（平均值）。术后恢复顺利，无吻合口瘘或狭窄并发症。没有进行长期随访。5毫米腹腔镜吻合器提供了一个有吸引力的替代开放式新生儿肠吻合，特别是在方便和时间的吻合。其在新生儿肠道重建中的更广泛应用有待进一步的科学研究。
Recently, a 5 mm laparoscopic stapler entered the market and is currently used for a wide variety of pediatric applications. The aim of this article is to be the first report of the use of this 5 mm laparoscopic stapler for open neonatal intestinal anastomosis in humans. We used JustRight (Justright Surgical) 5 mm laparoscopic staplerA (R) in 5 patients, with a total of six anastomoses being constructed. Enteroenterostomies after bowel resection were performed in these neonates with diagnoses of closed gastroschisis with ileal atresia, multiple intestinal atresia, ileal atresia, and jejunal atresia. Side-to-side, functional end-to-end, stapled anastomoses were performed in the standard antimesenteric manner. Using 2.5 cm long staple loads, the anastomoses approximated 1.5 cm. Minimal staple line overlap was incurred. Enteral feedings were initiated, and nutritional goals met, on postoperative days 8 and 15.2, respectively (means). Postoperative recovery was uneventful, notably without anastomotic complications of leak or stenosis. No long-term follow-up was done. The 5 mm laparoscopic stapler offers an attractive alternative in open neonatal intestinal anastomosis, particularly in both ease and time of anastomosis. Its more generalized use in neonatal intestinal reconstruction awaits further scientific investigation.