L. Dewberry1, S. A. Hilton1, K. W. Liechty1 1University Of Colorado Denver,Department Of Surgery,Aurora, CO, USA
Introduction:
Intestinal atresia is a congenital defect resulting in intestinal discontinuity and can be associated with significant morbidity related to intestinal failure. The bowel proximal to the atresia is often significantly dilated and dysfunctional. The treatment approaches of this dilated bowel include resection with primary anastomosis versus tapering enteroplasty with preservation of bowel length. The purpose of this study was to compare these two approaches in regard to bowel function as characterized by time to full enteral feeding.
Methods:
A retrospective review was performed of intestinal atresia repair performed at a tertiary referral pediatric hospital from 2007-2017. Length of stay, time to full enteral feeds, and complications were compared between those who underwent repair with tapering enteroplasty (n=8) versus those who underwent resection and anastomosis (n=39).
Results:
The median age at surgery, gender distribution, and association with gastroschisis were similar between the two groups. Other atresia characteristics such as location and atresia type were comparable as well with the exception of more type IIIB and type IV atresias in the non-tapered group. Overall, there was no statistically significant difference in length of stay and time to full enteral feeds between groups (Table 1)
In the non-tapered group, 5/39 (12.8%) underwent further surgical exploration with tapering enteroplasty due to bowel dysmotility. In this group, the median length of stay was 73 (62-136) days, and the median time to full enteral feeds was 63 (51-104) days.
Conclusion:
Tapering enteroplasty at initial operation for intestinal atresias preserves bowel length and may avoid the need for further surgery as evidenced by the non-tapered group requiring re intervention with tapering enteroplasty due to bowel dysmotility.
