Is trisomy 21 a risk factor for postoperative complications after pediatric surgery for neonatal gastrointestinal...

Trisomy 21 is associated with neonatal surgical disorders, such as duodenal atresia, Hirschsprung's disease, and anorectal malformation (ARM). Therefore, the purpose of this study was to compare postoperative complications in patients with vs. without trisomy 21 who underwent neonatal gastrointestinal surgery and to identify risk factors for postoperative complications after these surgeries in the Japanese population.

From the National Clinical Database-Pediatric, we selected patients with duodenal atresia/stenosis, Hirschsprung's disease, and ARM operated in the neonatal period from 2016 to 2020 and analyzed the risk factors for postoperative complications.

Duodenal atresia/stenosis, Hirschsprung's disease, and ARM were diagnosed in 4052 patients, of which 2486 patients were operated on in the neonatal period. These patients comprised 801 with duodenal atresia/stenosis, 289 with Hirschsprung's disease, and 1446 with ARM. The numbers of patients with complicated trisomy 21 were 212 (26.5%), 16 (5.5%), and 102 (7.1%) for duodenal atresia/stenosis, Hirschsprung's disease, and ARM, respectively. Regarding duodenal atresia/stenosis, multivariable logistic regression analysis showed that trisomy 21 were risk factors for postoperative complications.

In this analysis of Japanese data, trisomy 21 was an independent risk factor for postoperative complications in patients with duodenal atresia/stenosis.