等径手缝侧对侧肠一期吻合：中性粒细胞减少性小肠结肠炎患儿肠切除术后的安全方法。

IF 1.6 4区医学 Q2 SURGERY

Surgery Today Pub Date : 2025-08-01 Epub Date: 2025-02-01 DOI:10.1007/s00595-025-02998-z

Mohammad Taher, Maged Elshafiey, Ahmed Refaat, Eman Nasr, Gehad Ahmed

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引用次数: 0

摘要

背景与目的：在小儿肿瘤合并中性粒细胞减少性小肠结肠炎（NEC）患者中，肠切除术后是进行一期吻合（PA）还是造口一直是困扰患者的难题。PA后的泄漏风险必须与造口并发症的风险相权衡。我们评估了有PA或造口的NEC患者的治疗结果，以及PA中等径手工缝合侧对侧吻合（ISSA）技术的应用。患者与方法：回顾性研究2008年至2022年在我院行手术探查的所有埃及儿童肿瘤医院NEC患者。结果：153例患儿中，80例（52.3%）行PA， 73例（47.7%）行造口术。80例PA患者中，68例（85%）行ISSA吻合，9例（11.2%）行端侧吻合（EEA）， 3例（3.8%）行端侧吻合（ESA）。造口组围手术期并发症发生率为38/73 (52.1%)，PA组为35/80（43.8%）。ISSA患者中有6/68例（8.8%）、EEA患者中有5/9例（55.6%）、ESA患者中有1/3（33.3%）发生渗漏。结论：对于患有NEC的儿童癌症患者，肠切除术后使用ISSA的PA被认为是比任何其他吻合方式更好的方法。

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查看原文本刊更多论文

Isoperistaltic hand-sewn side-to-side bowel primary anastomosis: a safe approach after bowel resection in children with neutropenic enterocolitis.

Background and aim: Whether to perform primary anastomosis (PA) or create a stoma after bowel resection has always been a dilemma in pediatric cancer patients with neutropenic enterocolitis (NEC). The risk of leakage after PA must be weighed against the risk of stoma complications. We evaluated the outcomes of managing NEC patients with either PA or stoma and the utility of the isoperistaltic hand-sewn side-to-side anastomosis (ISSA) technique in PA.

Patients and methods: A retrospective study on all Children's Cancer Hospital Egypt patients with NEC who underwent surgical exploration at our hospital from 2008 to 2022.

Results: Of 153 children, 80 (52.3%) underwent PA and 73 (47.7%) underwent stoma formation. Among the 80 PA patients, 68 (85%) underwent ISSA, 9 (11.2%) end-to-end anastomosis (EEA), and 3 (3.8%) end-to-side anastomosis (ESA). The perioperative complication rate was 38/73 (52.1%) in the stoma patients and 35/80 (43.8%) in the PA patients. Leakage occurred in 6/68 (8.8%) ISSA patients, 5/9 (55.6%) EEA patients, and 1/3 (33.3%) of ESA patients.

Conclusions: In pediatric cancer patients with NEC, PA using ISSA after bowel resection is considered a better approach than any other anastomotic configuration.

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来源期刊

Surgery Today 医学-外科

CiteScore

4.90

自引率

4.00%

发文量

208

审稿时长

1 months

期刊介绍： Surgery Today is the official journal of the Japan Surgical Society. The main purpose of the journal is to provide a place for the publication of high-quality papers documenting recent advances and new developments in all fields of surgery, both clinical and experimental. The journal welcomes original papers, review articles, and short communications, as well as short technical reports("How to do it"). The "How to do it" section will includes short articles on methods or techniques recommended for practical surgery. Papers submitted to the journal are reviewed by an international editorial board. Field of interest: All fields of surgery.