Volume 8, Issue 2 (9-2022)
CJP 2022, 8(2): 0 |
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Raman V S, Singh V K, Nair V V, Nagamahendran R, Dwivedi D, Baunthiyal V. A Retrospective Analysis of Duodenal and Jejunoileal Atresia: Five-Year Experience from a Tertiary Care Pediatric Surgery Center in Western India. CJP 2022; 8 (2) :702-710
URL: http://caspianjp.ir/article-1-181-en.html
URL: http://caspianjp.ir/article-1-181-en.html
V Shankar Raman 
, Vivek K Singh , Vipin Venugopal Nair * , R Nagamahendran , Deepak Dwivedi , Vinay Baunthiyal
, Vivek K Singh , Vipin Venugopal Nair * , R Nagamahendran , Deepak Dwivedi , Vinay Baunthiyal
Associate Professor, Department of Surgery; Armed Forces Medical College, Pune, Maharashtra, India , vipinvenugopalnair@gmail.com
Abstract: (1594 Views)
Background and Objective: 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).
Methods: Retrospective descriptive analysis of patients operated between March 2015 to February 2020 in a tertiary-care Pediatric 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. Demographic and clinical information and data were analyzed with SPSS version 26 with appropriate statistical tools.
Findings: 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.
Conclusion: 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.
Methods: Retrospective descriptive analysis of patients operated between March 2015 to February 2020 in a tertiary-care Pediatric 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. Demographic and clinical information and data were analyzed with SPSS version 26 with appropriate statistical tools.
Findings: 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.
Conclusion: 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.
Keywords: Duodenal Atresia, Duodenoduodenostomy, Intestinal Atresia, Jejuno-Intestinal Atresia, Resection Anastomosis, Tapering Enteroplasty
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