- Surgical treatment of congenital jejunoileal obstruction in newborns
Surgical treatment of congenital jejunoileal obstruction in newborns
Paediatric Surgery.Ukraine.2017.2(55):70-75; doi 10.15574/PS.2017.55.70
Sliepov O., Migur M., Soroka V.
SI «Institute of Pediatrics, Obstetrics and Gynecology of NAMS of Ukraine», Kyiv
Rationale. According to the current literature, the issue of rational approaches for the surgical treatment of neonates with congenital jejunoileal obstruction remains controversial.
Objective: to investigate the efficacy of different types of surgical interventions and their impact on outcomes in newborns with jejunoileal obstruction.
Materials and methods. A retrospective analysis of medical records of 35 infants with jejunoileal obstruction was performed. To investigate the impact of different types of surgery on treatment results, all patients were divided into two groups. The children with jejunoileal obstruction, who had primary anastomosis of the small intestine during surgery were included into the 1st group (n=17). Into the 2nd group the infants who underwent the different types of intestinal stomas during primary surgery (n=12) were enrolled. The patients who had jejunoileal obstruction associated with gastroschisis (n=6) were excluded from the study.
Results. No significant difference between the diameters of the proximal and distal ileac segments among the children from the studied groups found (P>0.05). Children who underwent different types of intestinal stomas during the primary sugery had a greater incidence rate of sepsis, the significantly longer parenteral nutrition (P<0.05) and the time of conversion to the full enteral nutrition (P<0.05), as well as duration of hospitalization (P<0.05). The employment of ostomy did not lead to improvement of clinical outcomes and mortality reduction.
Conclusions. The primary anastomosis of the small intestine is the best method of surgical treatment of jejunoileal obstruction in newborns. However, the employment of intestinal ostomy does not improve outcomes.
Key words: congenital jejunoileal obstruction, anastomosis, stoma, newborn.
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