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A Retrospective Analysis of Duodenal and Jejunointestinal Atresia-Five-Year Experience from a Tertiary Care Paediatric Surgery Center in Western India.
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V Shankar Raman  , Vivek K Singh , Vipin V Nair * , R Nagamahendran , Deepak Dwivedi , VInay Baunthiyal |
| Associate Professor, Department of Surgery; Armed Forces Medical College, Pune, Maharashtra, India , vipinvenugopalnair@gmail.com |
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Abstract: (724 Views) |
Background: Intestinal atresia is a life-threatening problem requiring early active intervention. The aim of the study was to compare management outcomes between Duodenal-Atresia (DA) and Jejunoileal-Atresias (JIA). The secondary objective was to analyse tapering enteroplasty versus end-to-end anastomosis in JIA.
Materials and Methods: Retrospective descriptive analysis of patients operated between Mar 2015 to Feb 2020 in a tertiary-care Paediatric Surgery unit of Armed Forces Medical College Pune ,India. The data was obtained from the hospital records, operation theatre notes, discharge summary, and follow-up notes. Additional data was obtained by a telephonic conversation with the parents. Data were analysed with SPSS version 26 with appropriate statistical tools.
Results: Forty-eight neonates were included (DA=23; JIA=25).There were 18 (37.5%) males and 30 (62.5%) females.The mean age, mean birth weight, and time to feed were statistically significant and better in JIA compared to DA. A total of 45% of newborns had associated anomalies. The primary surgery performed in patients with DA was Kimura's duodenoduodenostomy, while Resection-anastomosis with or without tapering enteroplasty was performed in JIA patients. In the subgroup analysis of JIA, the length of hospital stay in the tapering enteroplasty was statistically significant compared to resection anastomosis.(p=0.048). The average weight gain and survival in Jejunoileal-atresia at six months is statistically significant compared to Duodenal-atresia
Conclusions: The management of intestinal atresias is challenging and requires a dedicated team in a specialized neonatal intensive-care unit. Intensive investigation of other congenital anomalies associated with the condition is equally critical, and in the subgroup analysis of JejunoIlial -atresia, the patients undergoing tapering enterostomy showed better survival compared to resection and end to end anastomosis only.
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| Keywords: Intestinal Atresia, Duodenal Atresia, Jejuno-Intestinal Atresia, Resection Anastomosis, Tapering Enteroplasty, Duodenoduodenostomy |
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Type of Study: Research |
Subject:
General
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