- Influence of the Eviscerated Bowel Status on Digestive Tract Motility Recovery After Surgery for Gastrochisis in Neonates
Influence of the Eviscerated Bowel Status on Digestive Tract Motility Recovery After Surgery for Gastrochisis in Neonates
PAEDIATRIC SURGERY.UKRAINE.2018.1(58):75-80; doi 10.15574/PS.2018.58.75
Sliepov O. K., Migur M. Yu., Ponomarenko O. P., Tabachnikova E. Yu.
SI «Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine», Kyiv
Background. According to current literature, intestinal damage in gastroschisis (GS) leads to an increase in morbidity and mortality. However, the correlation between impairment degree of the eviscerated bowel and the restoration of gastrointestinal motility (GIM) after the operation remains unresolved issue.
Objective: to determine the impact of the impairment degree of eviscerated intestine on the restoration of GIM after surgery for GS.
Material and methods. The analysis of treatment results of 51 patients with simple GS who recovered after the surgical treatment was performed. All patients were divided into three groups. Group 1 included patients with intact bowel (n=12, 23.5%). Newborns with moderate intestinal damage were included to the 2nd group (n=23, 45.1%). In the 3rd group, severe bowel damage was diagnosed (n=16; 31.4%).
Results. In patients who were enrolled to the study the terms of active peristalsis and stools appearance, gastrostasis duration, time of complete enteral nutrition achievement in the postoperative period were studied. After assessing the statistical significance of the difference between 1 and 2 groups, there were no significant differences in the studied statements (P≥0.05; p=0.05–0.27). The assessment of the statistical significance of the difference between the first two groups and the third group showed a significant difference in terms of active peristalsis appearance (р˂0.01), gastrostasis discontinuation (p=0.01), bowel movements uprise (p=0.01) and the time of introduction (p=0.01) and achievement of complete enteral nutrition (p=0.02).
Conclusions. Mild and moderate intestinal damage had minor effect on the restoration of GIM. The severe damage of the eviscerated bowel loops has significant effect on the GIM restoration in the postoperative period.
Key words: gastroschisis, eviscerated organs status, motility restoration, newborns.Level of evidence: Level III, retrospective comparative study.
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