Intestinal flow after anastomotic operations in neonates

Ito, Y.; Asato, Koichiro; Cho, Inhyeok; Sakai, Yasuhiko; Iwano, Koji; Tainaka, Takahisa; Uchida, Hiroo

doi:10.1016/j.compbiomed.2019.103471

Cited by 5 publications

(3 citation statements)

References 22 publications

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“…[8][9][10][11] The above factors, combined with the reduced gradient pressure at the anastomotic site, ultimately result in poor passage of intestinal contents or even in the occurrence of NEC. 12 In the present study, we observed that the incidence of NEC after JIA repair was not correlated with demographic or pathological features of the patients. We found that PJA was more likely to be concurrent with NEC.…”

Section: Discussioncontrasting

confidence: 48%

Clinical characteristics of postoperative necrotizing enterocolitis in patients with congenital jejunoileal atresia and its risk factors

Xiong,

Lu,

Xing

et al. 2024

World Jnl Ped Surgery

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ObjectiveTo review postoperative necrotizing enterocolitis (NEC) in patients with jejunoileal atresia (JIA) and to explore the potential risk factors related to the concurrence of NEC.MethodsPatients diagnosed with JIA who received surgical treatment from January 2016 to June 2021 were enrolled. Demographics, viral infection of the fetus, transfusion within 48 hours before NEC, sepsis before JIA repair, pathological and anatomical classification of JIA, combined malformation, occurrence time of NEC after the operation, treatment, and prognosis of patients were analyzed. Patients were divided into NEC group and non-NEC group, and all patients were followed up for 3–6 months to observe for complications.ResultsA total of 180 patients with JIA were included, of whom 12 were diagnosed with NEC after surgery and 1 patient with NEC died during follow-up. The average age, birth weight, gestational age, proportion of premature infants, proportion of preoperative infections, and pathological classification of JIA did not significantly differ between the two groups. The probability of patients with proximal jejunal atresia (PJA) in the NEC group (58.3%) was higher than that in the non-NEC group (22.6%) (p=0.011), and patients with PJA had longer parenteral nutrition time than patients without PJA (26.64±9.21 days vs 15.11±6.58 days,p<0.001).ConclusionPJA was more likely to be associated with concurrent NEC after surgery, which is a highly NEC-related risk factor inherent in JIA.

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Section: Discussioncontrasting

confidence: 48%

Clinical characteristics of postoperative necrotizing enterocolitis in patients with congenital jejunoileal atresia and its risk factors

Xiong,

Lu,

Xing

et al. 2024

World Jnl Ped Surgery

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“…Moreover, as explained in several articles on fluid dynamics in anastomoses [20,21], the distal part plays a crucial role in bolus progression, emphasizing the importance of preserving vascularity. Interrupting bowel continuity with an ostomy may pose greater risks of complications due to the exclusion of the distal part, which does not contribute to bolus progression [22][23]..…”

Section: Discussionmentioning

confidence: 99%

Apple-Peel intestinal atresia: A systematic review

Laconi,

Bischoff,

Michailos

et al. 2024

J Neonatal Surg

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Background: Apple-peel bowel atresia (APA) is rare and thus lacks proper management guidelines. This systematic review analyzes various interventions found in the literature for this type of atresia and highlights the outcomes of each intervention with their complications. Methods: The relevant literature on PubMed, Scopus, Embase, and Cochrane was reviewed from November 2020 to January 2021. Articles published in English, French, Italian, or Spanish between 1990 and 2020, focusing on APA, were included. Data on demography, clinical profile, management provided, time to achieve full feed, length of hospital stay, complications, etc., reviewed. Results: A total of 2495 articles were found, of which only 48 met the inclusion criteria. Among these, 125 patients were treated, with 15 deaths. The most frequently employed intervention was primary resection, with or without tapering, while ostomy creation was less commonly used. The most frequent complication across all techniques appeared to be cholestasis, followed by stenosis of the anastomosis and sepsis. Additionally, there were a total of 7 cases of short bowel syndrome (SBS). Conclusion: The management of apple-peel atresia seems variable in various centers of different countries. The review failed to assess which interventions could lead to faster full enteral feeding. The distal part of the anastomosis must be considered as an active part in the resumption of bowel function.

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“…The flow rate,as a measure of the driving force of the flow on the proximal side,increases when the amplitude of the peristaltic motion is large and the diameter is small,from a fluid dynamic point of view.The tapering technique has been developed to gradually modify the caliber gap [3] . In this technique,part of the intestine on the proximal side is removed from the proximal to the distal direction.However, there are still difficulties in performing proximal tapering and shaping anastomosis for intestinal atresia located at the beginning of the jejunum.…”

Section: Introductionmentioning

confidence: 99%

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

Zhao,

zhang,

2023

Eur J Pediatr Surg

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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.

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Intestinal flow after anastomotic operations in neonates

Cited by 5 publications

References 22 publications

Clinical characteristics of postoperative necrotizing enterocolitis in patients with congenital jejunoileal atresia and its risk factors

Clinical characteristics of postoperative necrotizing enterocolitis in patients with congenital jejunoileal atresia and its risk factors

Apple-Peel intestinal atresia: A systematic review

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

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