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Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Meconium ileus--is a single surgical procedure adequate?
1Department of Pediatric Surgery, Dana Children's Hospital, Tel-Aviv Medical Center and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. hnagar@@post.tau.ac.il
Asian Journal of Surgery
|August 1, 2006
Summary
Meconium ileus, a cystic fibrosis complication, requires surgery when conservative treatments fail. A single enterotomy, irrigation, and closure procedure effectively resolved obstruction in newborns, avoiding repeat surgeries.
Area of Science:
- Pediatric Surgery
- Neonatology
- Medical Genetics
Background:
- Meconium ileus is a significant gastrointestinal complication in 15% of neonates with cystic fibrosis (CF).
- It arises from the obstruction of the small intestine by inspissated meconium.
- Both nonoperative and operative strategies exist for managing meconium ileus.
Purpose of the Study:
- To evaluate the efficacy of a single surgical intervention for uncomplicated meconium ileus.
- To determine the preferred surgical approach for neonates with meconium ileus unresponsive to conservative management.
- To assess the long-term outcomes of surgical management in CF patients.
Main Methods:
- Retrospective review of five newborns with uncomplicated meconium ileus treated between 1991 and 2003.
- All patients underwent laparotomy, enterotomy, appendectomy, irrigation, and primary closure of the enterotomy.
- Genetic testing confirmed cystic fibrosis in all patients and carrier status in their parents.
Main Results:
- Conservative management failed in all five neonates, necessitating surgical intervention.
- A single surgical procedure (enterotomy, irrigation, and closure) was sufficient for all patients.
- No patient required a second surgical intervention.
- Cystic fibrosis was confirmed in all cases, with both parents being carriers.
Conclusions:
- Enterotomy with irrigation and primary closure is an effective surgical treatment for uncomplicated meconium ileus.
- A single surgical intervention is recommended for meconium ileus in CF patients due to the high risk of pulmonary complications.
- Early surgical intervention with this approach can prevent the need for further procedures.
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