• Efficacy of enteral probe after duodenoplasty in newborns

Efficacy of enteral probe after duodenoplasty in newborns

PERINATOLOGIYA I PEDIATRIYA. 2017.1(69):109-114; doi 10.15574/PP.2017.69.109

Efficacy of enteral probe after duodenoplasty in newborns

Sliepov O., Migur M., Soroka V.
SI «Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine», Kyiv

Purpose — to investigate the efficacy of enteral probe usage after duodenoplasty in newborns with congenital high small-bowel obstruction.

Materials and methods. A retrospective analysis of 46 newborns case histories with high small-bowel obstruction was conducted. To study the efficacy of the enteral probe, all patients were divided into two groups. The first group (index) included children with high small-bowel obstruction who were performed duodenoplasty during the surgery (n=34; 73.9%). The second group (comparison) comprised infants with small-bowel obstruction whom duodenoplasty was not performed (n=12; 26.1%).

Results. Duodenoplasty significantly increased the timing of gastrointestinal transit renewal (p=0.02, P<0.05). Despite the early enteral nutrition in children with established enteral probe (in both groups), significant differences in terms of full renewal of bowel motility in the postoperative period were not found (p=0.07, P>0.05). Gastrostasis was significantly longer in the index group (p=0.01, P<0.05) and in the comparison group (p=0.01, P<0.05) among children with enteral probes. In all cases gastrostasis stopped only after the removal of enteral probe and more significantly among children without duodenoplasty (r=0.03, P<0.05). Due to significantly longer duration of gastrostasis in children with enteral probes, enteral nutrition per os were initiated later (P<0.05). Children who underwent duodenoplasty without enteral probes, full enteral nutrition started significantly earlier (p=0.03, P<0.05).

Conclusions. Establishing of enteral probe above the line of duodenal anastomosis leads to postpone of gastrointestinal transit renewal of the upper gastrointestinal tract and of the full enteral nutrition.

Key words: congenital small$bowel obstruction, duodenoplasty, enteral probe, newborns.


1. Sliepov OK, Soroka VP, Ponomarenko OP et al. 2015. Successful staged surgical repair of the right congenital diaphragmatic hernia complicated by barotrauma of hypoplastic lungs and duodenal obstruction in premature neonate. Perinatologiya i pediatriya. 1: 95—100. doi 10.15574/PP.2015.61.95

2. Davenport M, Pierro A. 2009. Intestinal atresia. Paediatric surgery. Oxford University Press, Oxford: 146—151. https://doi.org/10.1093/med/9780199208807.001.0001

3. Upadhyay V, Sakalkale R, Parashar K et al. 1997. Duodenal atresia: a comparison of three modes of treatment. European Journal of Pediatric Surgery: 75—77.

4. Applebaum H, Grosfeld JL, O'Neill JA, Fonkalsrud EW et al. 2006. Duodenal atresia and stenosis — annular pancreas. Pediatric surgery. Mosby, Philadelphia: 1260—1268.

5. Sandblom P, Ehrenpreis T. 1949. Duodenal atresia and stenosis. Acta Paediatr: 109—134.

6. Ernst NP. 1916. A case of congenital atresia of the duodenum treated successfully by operation. British Medical Journal: 644—645. https://doi.org/10.1136/bmj.1.2888.644; PMid:20768119 PMCid:PMC2347754

7. Holcomb GW III, Murphy JP, Ostlie DJ. 2014. Ashcraft's Pediatric Surgery. 6th ed. Philadelphia, Еlsevier saunders: 1040.

8. Mooney D, Lewis JE, Connors RH et al. 1987. Newborn duodenal atresia: an improving outlook. The American Journal of Surgery: 347—349. https://doi.org/10.1016/0002-9610(87)90574-5

9. Nixon HH, Tawes R. 1971. Etiology and treatment of small intestinal atresia: analysis of a series of 127 jejunoileal atresias and comparison with 62 duodenal atresias. Surgery: 41—51. PMid:5538950

10. Bishay M, Lakshminarayanan B, Arnaud A et al. 2013. The role of parenteral nutrition following surgery for duodenal atresia or stenosis. Pediatric Surgery International: 191—195. https://doi.org/10.1007/s00383-012-3200-9; PMid:23187894

11. Hall NJ, Drewett M, Wheeler RA et al. 2011. Trans-anastomotic tubes reduce the need for central venous access and parenteral nutrition in infants with congenital duodenal obstruction. Pediatric Surgery International: 851—855. https://doi.org/10.1007/s00383-011-2896-2; PMid:21476073

12. Arnbjornsson E, Larsson M, Finkel Y et al. 2002. Transanastomotic feeding tube after an operation for duodenal atresia. European Journal of Pediatric Surgery: 159—162. https://doi.org/10.1055/s-2002-32727; PMid:12101496