Asymmetric figure-of-eight single-layer suture technique for intestinal anastomosis: A preliminary study.

Background: Anastomotic leakage is a life-threatening complication. Improvement of the anastomosis technique is needed, especially in patients with an inflamed edematous intestine. The aim of our study was to evaluate the safety and efficacy of an asymmetric figure-of-eight single-layer suture technique for intestinal anastomosis in pediatric patients. Methods: A total of 23 patients underwent intestinal anastomosis at the Department of Pediatric Surgery of Binzhou Medical University Hospital. Demographic characteristics, laboratory parameters, anastomosis time, duration of nasogastric tube placement, day of first postoperative bowel movement, complications, and length of hospital stay were statistically analyzed. The follow-up was conducted for 3-6 months after discharge. Results: Patients were divided into two groups: the single-layer asymmetric figure-of-eight suture technique (group 1) and the traditional suture technique (group 2). Body mass index in group 1 was lower than in group 2 (14.43 ± 3.23 vs. 19.38 ± 6.74; P = 0.036). The mean intestine anastomosis time in group 1 (18.83 ± 0.83 min) was less than that in group 2 (22.70 ± 4.11 min; P = 0.005). Patients in group 1 had an earlier first postoperative bowel movement (2.17 ± 0.72 vs. 2.80 ± 0.42; P = 0.023). The duration of nasogastric tube placement in group 1 was shorter than that in group 2 (4.12 ± 1.42 vs. 5.60 ± 1.57; P = 0.043). There was no significant difference in laboratory variables, complication occurrence, and length of hospital stay between the two groups. Conclusion: The asymmetric figure-of-eight single-layer suture technique for intestinal anastomosis was feasible and effective. More studies are needed to compare the novel technique with the traditional single-layer suture.

Alternative technique to save ischemic bowel segment in management of neonatal short bowel syndrome: A case report.

BACKGROUND: Congenital short bowel syndrome (SBS) associated with malrotation, gut volvulus and jejuno-ileal atresia is a very rare condition. It is a severe challenge for surgeons to preserve residual ischemic bowel segment in the management of short bowel syndrome,especially in neonates. CASE SUMMARY: We report a newborn baby with gut malrotation associated with jejuno-ileal atresia, congenital SBS and jejunal volvulus. Hematemesis and abdominal distention were noted. At laparotomy, malrotation associated with jejuno-ileal atresia, congenital SBS and jenunal volvulus was confirmed. The total length of the small bowel was 63 cm with proximal jejunal bowel segment measuring 38 cm, including 18 cm necrotic segment below the Treitz's ligament and 20 cm severe ischemic segment. The distal part of the small bowel was 25 cm in length and only about 0.8 cm in diameter. Ladd's procedure, necrotic segment resection and end-to-back duodeno-ileal anastomosis were performed. The residual severe ischemic jejunum was preserved with single proximal stoma and distal end closure. Three months later, to restore the continuity of the isolated gut segment, end-to-end duodeno-jejunal and jejuno-ileal anastomosis was performed. The entire functional small bowel length increased to 80 cm. Intravenous fluid therapy and parenteral nutrition were discontinued on the 10th day postoperatively. Twelve months later, her body weight was 9.5 kg. CONCLUSION: Isolation of severe ischemic bowel segment and staged anastomosis to restore the gut continuity for infants with SBS are safe and feasible.

[Diagnosis and treatment of schistosomiasis japonica-concensuses among ex- perts in Hunan, Hubei and Jiangxi provinces].

In order to further standardize the diagnosis and treatment of schistosomiasis japonica in China, on the basis of evidence-based medicine, the experts on schistosomiasis control from Hunan, Hubei and Jiangxi provinces summarized their consensuses on the disease after the discussion on the current situation and progress of clinical diagnosis and treatment of schistosomiasis in China, with the reference to the Diagnostic Criteria for Schistosomiasis (WS261-2006), which aimed to establish the therapeutic standards or guideline of schistosomiasis in China.

[Splenectomy and esophagogastric devascularization for advanced schistosomiasis with cavernous transformation of portal vein].

OBJECTIVE: To explore a surgical treatment of advanced schistosomiasis with cavernous transformation of the portal vein. METHOD: The clinical data of 18 patients who suffered from advanced schistosomiasis with cavernous transformation of the portal vein were collected and analyzed retrospectively in the Affiliated Xiangyue Hospital of Hunan Institute of Parasitic Diseases. RESULTS: Two cases were undertaken the endoscopic variceal ligation, and the upper gastrointestinal bleeding happened 32 months and 40 months after the treatment respectively, and they received the splenectomy and esophagogastric devascularization again; 16 cases were undertaken the splenectomy and esophagogastric devascularization. During the follow-up of 6-72 months, no esophageal and gastric varices were found. CONCLUSION: Splenectomy and esophagogastric devascularization is effective in the treatment of advanced schistosomiasis with cavernous transformation of the portal vein.