A stitch in time saves nine: suture technique does not affect intestinal growth in a young, growing animal model.

BACKGROUND: Although this issue remains unexamined, pediatric surgeons commonly use simple interrupted suture for bowel anastomosis, as it is thought to improve intestinal growth postoperatively compared to continuous running suture. However, effects on intestinal growth are unclear. We compared intestinal growth using different anastomotic techniques during the postoperative period in young rats.

METHODS: Young, growing rats underwent small bowel transection and anastomosis using either simple interrupted or continuous running technique. At 7-weeks postoperatively after a four-fold growth, the anastomotic site was resected. Diameters and burst pressures were measured.

RESULTS: Thirteen rats underwent anastomosis with simple interrupted technique and sixteen with continuous running method. No differences were found in body weight at first (102.46 vs 109.75g) or second operations (413.85 vs 430.63g). Neither the diameters (0.69 vs 0.79cm) nor burst pressures were statistically different, although the calculated circumference was smaller in the simple interrupted group (2.18 vs 2.59cm; p=0.03). No ruptures occurred at the anastomotic line.

CONCLUSIONS: This pilot study is the first to compare continuous running to simple interrupted intestinal anastomosis in a pediatric model and showed no difference in growth. Adopting continuous running techniques for bowel anastomosis in young children may lead to faster operative time without affecting intestinal growth.