Early Reoperations after Primary Repair of Jejunoileal Atresia in Newborns

Authors

  • Fanny Yeung Division of Paediatric Surgery & Paediatric Urology, Department of Surgery, The Chinese University of Hong Kong
  • Yuk Him Tam Division of Paediatric Surgery & Paediatric Urology, Department of Surgery, The Chinese University of Hong Kong
  • Yuen Shan Wong Division of Paediatric Surgery & Paediatric Urology, Department of Surgery, The Chinese University of Hong Kong
  • Siu Yan Tsui Division of Paediatric Surgery & Paediatric Urology, Department of Surgery, The Chinese University of Hong Kong
  • Hei Yi Wong Division of Paediatric Surgery & Paediatric Urology, Department of Surgery, The Chinese University of Hong Kong
  • Kristine Kit Yi Pang Division of Paediatric Surgery & Paediatric Urology, Department of Surgery, The Chinese University of Hong Kong
  • Christopher H Houben Division of Paediatric Surgery & Paediatric Urology, Department of Surgery, The Chinese University of Hong Kong
  • Jennifer Wai Cheung Mou Division of Paediatric Surgery & Paediatric Urology, Department of Surgery, The Chinese University of Hong Kong
  • Kin Wai Chan Division of Paediatric Surgery & Paediatric Urology, Department of Surgery, The Chinese University of Hong Kong
  • Kim Hung Lee

DOI:

https://doi.org/10.21699/jns.v5i4.444

Keywords:

Jejunoileal atresia, Primary resection and anastomosis, Reoperation

Abstract

Aim: To review nine-year experience in managing jejuno-ileal atresia (JIA) by primary resection and anastomosis and identify factors associated with reoperations.

Methods: From April 2006 to May 2015, all consecutive neonates who underwent bowel resection and primary anastomosis for JIA were analyzed retrospectively. Patients with temporary enterostomy were excluded. Patient demographics, types of atresia, surgical techniques, need for reoperations, and long-term outcomes were investigated.

Results: A total of forty-three neonates were included, in which nineteen (44.2%) of them were preterm and fourteen (32.6%) were of low birth weight. Thirteen patients (30.2%) had jejunal atresia whereas thirty patients (69.8%) had ileal atresia. Volvulus, intussusception and meconium peritonitis were noted in 12, 8, and13 patients, respectively. Eight patients (18.6%) had short bowel syndrome after operation. Ten patients (23.3%) required reoperations from 18 days to 4 months after the initial surgery due to anastomotic stricture (n=1), adhesive intestinal obstruction (n=1), small bowel perforation (n=2) and functional obstruction (n=6). Prematurity and low birth weight were associated with functional obstruction leading to reoperation (p=0.04& 0.01 respectively). The overall long-term survival was 97.7%. All surviving patients achieved enteral autonomy and catch-up growth at a median follow-up of 4.7 years.

Conclusion: Long-term survival of JIA after primary resection and anastomosis are excellent. However, patients have substantial risk of early reoperations to tackle intraabdominal complications.

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Published

2020-07-15

How to Cite

1.
Yeung F, Tam YH, Wong YS, Tsui SY, Wong HY, Pang KKY, Houben CH, Mou JWC, Chan KW, Lee KH. Early Reoperations after Primary Repair of Jejunoileal Atresia in Newborns. J Neonatal Surg [Internet]. 2020Jul.15 [cited 2021Apr.16];5(4):42. Available from: https://jneonatalsurg.com/ojs/index.php/jns/article/view/315