Reply to Letter to the Editor

Abstract

We have read with interest the letter to the editor by Soyer and Çakmak regarding our recent publication “Consecutive purse string suture for mesenteric defect closure after tumor resection in children” in the Journal of Pediatric Surgery [ [1] Fernandez-Pineda I. Cabello-Laureano R. Consecutive purse string suture for mesenteric defect closure after tumor resection in children. J Pediatr Surg. 2014; 49: 1186-1188 Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar ]. They reported that large mesenteric defects greater than 10 cm should be closed with a purse string technique and interrupted sutures [ [2] Çakmak M. Şenyücel M.F. Aslan M.K. et al. Surgical repair of Treves field mesenteric hernia: Use of purse-string technique. Eur J Pediatr Surg. 2011; 21: 337-339 Crossref PubMed Scopus (4) Google Scholar ]. Large congenital or acquired mesenteric defects in children are not very common and conclusions about the best surgical technique for defect closure are difficult to be drawn. We agree that the purse string technique permits a more anatomical closure of the mesentery avoiding a kink or twist in the bowel. Both consecutive purse string suture and interrupted stitches after the first purse string suture are good surgical options for definitive closure defect. Long-term outcomes about the best surgical approach for large mesenteric defects closure should be obtained from case series, prospective studies and not from case reports.