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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
Pediatric Surgery International
|July 23, 2011
Summary
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.
