A. Takahashi et al., Results of bowel plication in addition to primary anastomosis in patients with jejunal atresia, J PED SURG, 36(12), 2001, pp. 1752-1756
Background/Purpose: Disturbed intestinal transit (DIT) associated with bowe
l dilation occurs in some postoperative patients with jejunal atresia. Bowe
l plication (BP) has been introduced to prevent the DIT, but the long-term
results of BP are unclear.
Methods: The authors reviewed the preoperative and operative records and po
stoperative clinical courses (for 2.3 to 7.0 years; mean period, 3.7 years)
of 19 jejunal atresia patients, 4 of whom had undergone additional BP with
primary anastomosis after dilated bowel resection or tapering jejunoplasty
at neonatal surgery. The degree of DIT was evaluated by the clinical sympt
oms, weight gain, whether reoperation was performed, and duration from the
operation to receiving an oral feeding volume of at least 130 mL/kg/d. The
patients then were assigned 4 grades (0 to 3). To determine the presence or
absence of bowel dilation at the BP site, the plain abdominal x-rays were
reviewed.
Results: (1) Within 2 months after surgery, 4 patients without BP underwent
operation because of severe DIT. The degree of postoperative DIT in patien
ts who had received additional BP at neonatal surgery was less than that in
patients without BP (mean grade, 0,50 v. 2.08). (2) The preoperative clini
cal features, operative method, and postoperative weight gain were almost s
imilar in patients with and without BP. (3) On abdominal x-ray the bowel di
lation remained 6 to 12 months after the operation, but was not observed ov
er 1 year after the operation.
Conclusions: In this preliminary study, the addition of BP after tapering j
ejunoplasty or resection of dilated bowel may be effective in preventing ea
rly postoperative DIT. Further study is necessary to evaluate the long-term
results of additional BP at neonatal surgery. Copyright (C) 2001 by WB. Sa
unders Company.