Results of bowel plication in addition to primary anastomosis in patients with jejunal atresia

Citation
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
Citations number
9
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Pediatrics
Journal title
JOURNAL OF PEDIATRIC SURGERY
ISSN journal
0022-3468 → ACNP
Volume
36
Issue
12
Year of publication
2001
Pages
1752 - 1756
Database
ISI
SICI code
0022-3468(200112)36:12<1752:ROBPIA>2.0.ZU;2-I
Abstract
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.