Application of jejunal turnover and bowel plication technique in neonatal high intestinal atresia: a retrospective study

Abstract

Introduction:To evaluate the outcomes of jejunal turnover and bowel plication (JTBP) in high jejunal atresia of neonates. Materials and Methods:The clinical data of neonates met the criteria were retrospectively analyzed from January 2012 to December 2021.The neonates were divided into the JTBP group and control group according to the surgical procedure.Demographics, postoperative morphology of the duodenum and proximal jejunum,intestinal recovery time and complications were compared. Results:75 patients were allocated to the JTBP (n=30) and control (n=45) groups, respectively. There was no significant difference between the two groups in terms of gestational age, birth weight, age at surgery,the pathological classification,and concomitant disease. UGCS showed that the diameter of the proximal bowel of the anastomotic stoma was normal and the duodenum and proximal jejunumin streamline shape in the JTBP group.While the duodenum dilated, and the shape of Trojan angle was classified into sharp angle and blunt round angle in the control group.The duration of total parenteral nutrition, postoperative oral feeding time and oral feeding time of 40 mL/3 h was significantly different between the JTBP group and control group(sharp and blunt round type): 9.0±3.5d,7.0±2.1d and 11.0±6.0d vs 16.9±4.2 d, 14.0±5.0 d and 19.0±7.4 d vs 11.9±8.3 d, 8.2±3.9d and 15.8±3.6d(P<0.05). Conclusions: JTBP for neonatal high jejunal atresia can significantly change the diameter of the proximal bowel and the course of duodenum jejunum flexure. Postoperative bowel movement was more in line with fluid dynamics, which was conducive to the recovery of the intestinal function and resulted in fewer complications.