Surgical treatment of newborns with small bowel atresia (literature review)

Abstract

Intestinal atresia is a congenital obstruction of the lumen of the jejunum or ileum and is one of the most common causes of congenital obstruction in newborns. This literature review is devoted to the surgical treatment of newborns with various types intestinal atresia. Causes of intestinal atresia are considered, where a special role is assigned to the genetic theory, the expression of the nucleotide sequences ITGA2 873G/A and NPPA 2238T/C and antenatal circulatory disorders of the developing intestine. Topographical-anatomical and morphological characteristics of the intestine in newborns with intestinal atresia are studied in detail in articles. A table of revealed histomorphological features of the small intestine in children with atresia was compiled. In addition, processes occurring in the mucosa, submucosa, muscle, and serous membranes are described in detail. A relationship was found related to the size of the atresia site and duration of ischemia. The theory of neuromuscular regulation of the intestine is considered, in which an important role is assigned to interstitial pacemaker cells of Cajal. Variants of anastomosis depending on the difference in diameters of the adductor and excretory parts of the intestine are analyzed, and results of treatment in patients with laparoscopic access are described. The postoperative course of disease, development of complications, recurrent operative interventions, duration of parenteral nutrition, and onset of enteral load was evaluated.
 Conclusion. The choice of surgical technologies used to restore the patency of the intestinal tube is determined by the degree of discrepancy between diameters of anastomosed segments. The prognosis is not determined by tactics of surgical treatment, type of atresia, time before treatment, and presence of associated anomalies.