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    Comparison of Stapler and Hand-Sewn Roux en Y Jejunal Anastomosis in Children
    (2022) Alkan, Murat; Tutus, Kamuran; Colak, Selcan Turker; Fakioglu, Ender; Kilic, Seref Selcuk; Ozden, Onder; Tuncer, Recep; https://orcid.org/0000-0003-2469-9963
    Purpose: This study aims to evaluate and compare the outcomes of stapled and hand-sewn Roux-en-Y intestinal anastomoses in childhood.Materials and Methods: At a university hospital, the records of the children who underwent roux-en-Y anastomosis between December 2007 and December 2014 were reviewed. The data were compared according to the roux-en-Y anastomosis technique used (stapled versus hand-sewn).Results: A total of 52 patients had undergone roux-en-Y anastomosis. All had biliary atresia or choledochal cyst. Thirty-one of the patients were diagnosed with biliary atresia and 21 with choledochal cysts. Staple anastomosis technique was used in 16 of the patients with biliary atresia and 9 of the patients with choledochal cyst. Both in biliary atresia and choledochal cyst cases; operations with stapled anastomosis were significantly shorter than the ones with hand-sewn anastomosis. Among the biliary atresia cases, post-operative oral feeding was initiated significantly earlier in the stapled group, with its lower risks of post-operative cholangitis and longer hospital stay than 7 days.Conclusion: This is the first study in children, confirming the time-saving advantage of stapled anastomosis over hand-sewn, during roux-en-Y anastomosis for biliary atresia and choledochal cyst; along with the safety of stapler use, including the neonates. Stapled anastomosis yields lower complication rates, faster function gain with earlier feeding and hospital discharge.
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    Vascular Variations and Anastomosis Techniques in Renal Transplant Donors
    (2015) Haberal, Mehmet; Arer, Ilker Murat; Yabanoglu, Hakan; Caliskan, Kenan; Parlakgumus, Alper; Yildirim, Sedat; Moray, Gokhan
    Purpose: We aimed to share our experience about vascular variations and anastomosis tecniques in renal transplant donors. Material and Methods: 128 donor nephrectomy performed in our hospital between February 2010 and June 2014 were included in our study. Donors were retrospectively analyzed according to age, sex, comorbidity, operation history, site of nephrectomy, vascular variation and anastomosis techniques. Results: 21 (% 16,4) patients have left-sided, 19 (% 14,8) have right-sided and 13 (% 10,2) have bilateral vascular variation. 29 (% 21,2) unilateral double renal artery, 8 (% 6,3) unilateral double renal artery and vein, 4 (% 3,2) unilateral triple renal artery, 3 (% 2,4) early branching renal artery, 2 (% 1,6) unilateral double renal vein and 2 (% 1,6) polar artery are vascular variations observed. of 92 (% 71,9) recepients anastomosis type was end to side between renal artery and external iliac artery and end to side between renal vein and external iliac vein, 32 (% 25) end to end between renal artery and external iliac artery and end to side between renal vein and external iliac vein, 4 (% 3,1) end to side between renal artery and external iliac artery and end to side between renal vein and external iliac vein and end to side between 2nd renal artery and external iliac artery. Conclusion: Preoperative evaluation of renal vasculature of transplant donors is an important issue in means of decreasing peroperative vascular complications and decision for nephrectomy site.