Related Experiment Video
Updated: May 30, 2026
Caudal-to-cranial Approach in Laparoscopic Right Hemicolectomy with Complete Mesocolon Excision and D3 Lymph Node Dissection
Published on: January 9, 2026
Proximal colonic atresia: is right hemicolectomy inevitable?
Richard J England1, Simon Scammell, Govind V Murthi
1Paediatric Surgery Unit, Sheffield Children's Hospital NHS Trust, Sheffield, UK. r.england@doctors.org.uk
Insights
Proximal colonic atresia presents challenges in restoring bowel continuity due to differing end sizes. Right hemicolectomy and ileo-colic anastomosis are recommended for initial surgical repair.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
- Congenital Anomalies
Background:
- Proximal colonic atresia often involves significant caliber discrepancy between the atretic ends.
- Restoring bowel continuity in these cases presents a surgical challenge.
Purpose of the Study:
- To review a series of patients with colonic atresia.
- To evaluate techniques for restoring bowel continuity in proximal colonic atresia.
Main Methods:
- Retrospective review of case notes for patients diagnosed with colonic atresia between 1997 and 2011.
- Analysis of surgical procedures and outcomes.
Main Results:
- 13 patients with proximal colonic atresia were identified.
- 10 out of 12 patients ultimately required a right hemicolectomy to achieve bowel continuity.
- Median time to full feeds was 11 days.
Conclusions:
- A temporary stoma does not resolve the caliber discrepancy in proximal colonic atresia.
- Right hemicolectomy with ileo-colic anastomosis should be considered as the primary surgical approach.
Purpose:
Proximal colonic atresia often results in a marked discrepancy of the atretic ends presenting a technical challenge for restoration of bowel continuity. We review our series of colonic atresia patients with particular reference to the techniques for restoring bowel continuity.
Methods:
Case notes of all patients diagnosed with colonic atresia and admitted to our unit between 1997 and 2011 were reviewed.
Results:
There were 13 patients with a median gestational age of 39 weeks. Location of the atresia was ascending colon (n = 1), hepatic flexure (n = 9), proximal transverse colon (n = 2) and sigmoid colon (n = 1). The primary procedure was: primary anastomosis (n = 1), right hemicolectomy followed by ileo-colic anastomosis (n = 2), right hemicolectomy and stoma formation (n = 3). Six patients underwent stoma formation, of which five subsequently had a right hemicolectomy at a later procedure. In total, 10/12 patients required right hemicolectomy to facilitate restoration of bowel continuity. Median time to full feeds was 11 days (4-46). Median follow up time was 11 months (22 days-5.6 years).
Conclusion:
A temporising stoma does not reduce the discrepancy in the calibre of the atretic ends in proximal colonic atresia. Right hemicolectomy and ileo-colic anastomosis should therefore be considered at the initial surgery.
