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Small Intestinal Atresia: Should We Preserve the Peel or Toss It?
Benedetta Marino1, Giulia Mottadelli2, Marta Bisol1
1UOC Pediatric Surgery, Department of Women's and Children's Health, University of Padua, 35128, Padua, Italy.
Background:
Apple peel atresia (APA) is a rare and severe form of intestinal atresia, but little is known on long-term outcomes. We compared outcomes of apple-peel atresia based on different surgical approaches.
Methods:
a retrospective review from two institutions compared APA-resected and APA-preserved patients. Demographics, operative details, postoperative courses and long-term outcomes were analyzed.
Results:
Of the 16 APA neonates, 10 (62.5%) were in APA-resected and 6 (37.5%) in APA-preserved groups. Early postoperative complications occurred in 7 patients (43.75%) including vomiting, infection, intestinal occlusion, anastomotic dehiscence, multiorgan failure, equally distributed among groups. Length-of-stay is higher in the APA-preserved group (median 67 vs. 27 days, p = 0.14). Overall survival at discharge was 87.5%. Twelve children (75%) were followed for an average of 5 years. Reoperation was required in 4 children owing to anastomotic obstruction and adhesive intestinal obstruction, two in each group.
Conclusion:
to prevent intestinal failure, keeping the APA shows not inferior results compared to resection, even though it may have a longer first-postoperative course.
