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Published on: September 22, 2023
Prolonged feeding difficulties after surgical correction of intestinal atresia: a 13-year experience
1Department of Pediatric Surgery, Xinhua hospital, Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Shanghai, 200092, China; Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, No. 1665, Kongjiang Road, Shanghai, 200092, China.
Insights
Several factors, including meconium peritonitis and short bowel syndrome, prolong oral feeding difficulties after intestinal atresia surgery. Alertness for these conditions can reduce complications and costs.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Gastrointestinal Motility Disorders
Background:
- Surgical repair of intestinal atresia is generally successful.
- However, some neonates experience oral feed intolerance postoperatively.
- Identifying factors influencing oral feeding is crucial for improved outcomes.
Purpose of the Study:
- To identify factors affecting postoperative oral feeding in neonates with intestinal atresia.
- To analyze the time to establishment of full oral intake (TOI) and length of hospital stay (LOS).
Main Methods:
- Retrospective analysis of neonates admitted between January 2000 and June 2013.
- Outcome measures included time to full oral intake (TOI) and length of hospital stay (LOS).
- Univariate and multiple regression analyses were employed.
Main Results:
- Multivariate analysis revealed significant associations between TOI and meconium peritonitis, luminal discrepancy, number of anastomoses, immature ganglion presence, and short bowel syndrome.
- Prematurity was linked to longer hospitalization but did not affect TOI.
- Overall survival was 85.7%.
Conclusions:
- Meconium peritonitis, luminal discrepancy, multiple anastomoses, immature ganglion, and short bowel syndrome are associated with prolonged feeding difficulties.
- Increased vigilance for these factors can mitigate postoperative morbidity and reduce healthcare expenses.
Background:
Although surgical interventions for intestinal atresia are usually successful, oral feed intolerance could raise in certain cases. The aim of this study was to identify the factors that affect postoperative oral feed by retrospective analysis.
Methods:
Neonates meeting the inclusion criteria, who were admitted at our center from 1 January 2000 to June 2013, were enrolled into this retrospective study. Time to establishment of full oral intake (TOI), length of hospital stay (LOS) were outcome measures. Univariate and multiple regression were used.
Results:
Overall survival was 85.7%. Mean TOI was 20.4 ± 17.8 days, and mean LOS was 35.6 ± 44.8 days. Multivariate analysis confirmed a significant association with TOI for meconium peritonitis (P=0.024), luminal discrepancy between proximal and distal intestine (P=0.038), number of anastomoses (P=0.044), reportage of immature ganglion in proximal and/or distal intestine (P=0.029), and short bowel syndrome (P<0.001). Prematurity (P=0.022) increased the duration of hospitalization without affecting time to full oral intake.
Conclusions:
Meconium peritonitis, luminal discrepancy, number of anastomoses, reportage of immature ganglion, and short bowel syndrome were factors related to prolonged feeding difficulties. We advocate alertness for patients with these factors to reduce postoperative morbidity and treatment costs.
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