The role of routine transanastomotic T tube ostomy in jejunoilealatresia:A prospective, randomized study

Mohsen Rouzrokh, Azita Tavassoli, Alireza Mirshemirani, Parisa Azimi, Leili Mohajerzadeh, AhmadReza Shamshiri

Abstract


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Introduction: Jejunoileal atresia (JIA) is a common cause of neonatal intestinal obstruction and is a common surgical emergency. The aim of this study was to compare primary anastomosis without resection of the dilated segment with transanastomotic T tube jejunostomy (TATTO) versus resection of the dilated segment without T tube as the control group for treatment of patients with JIA.

Material and Methods: During 2008 to 2013, 105 patients were diagnosed with JIA at the time of surgery and were recruited for this study. Data relating to efficacy and procedural complications were compared among patients. The criteria for exclusion were duodenal obstruction, colonic atresia, intestinal perforation, malrotation, and also JIA patients with associated other anomalies like meconium ileous, gastroschisis and anorectal malformation.

Results: A total of 125 patients were diagnosed and 16 patients were excluded. Our patients were divided into a control group (n=52) and a TATTO group (n=57). The TATTO group had a significantly shorter postoperative hospital stay (12 vs. 23 days, p=0.001) and time to start feeding (9 vs. 13 days, p=0.003) compared with the control group. Sepsis (12.0% vs. 32.7% p=0.004), other complications (3.6% vs. 15.4% p=0.001) and the associated morbidity were significantly lower in the TATTO group.

Conclusion: The findings suggest that the TATTO technique was a better method for the treatment of children with JIA, as study showed lesser morbidity and mortality rates.

 


Keywords


Jejunoileal atresia; Primary anastomosis; Transanastomotic T tube ostomy, Outcome

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References


GrosfeldJL:Jejunoileal atresia and stenosis. In Grosfeld JL, O'Neill JA, Coran AG: Pediatric Surgery. 6th ed. Philadelphia: Mosby Elsevier, 2006, pp 1269-87.

Eltayeb AA: Different surgical techniques in management of small intestinal atresia in high risk neonates. Annals of pediatric surgery 2009; 5:31-35.

Shahjahan Md, Noor-ul Ferdous KaziMd, Ashrarur Rahman Mitul Md, et al: Management of Jejunoileal atresia: our 5 year experience. Chattagram Maa-O-Shishu Hospital College Journal 2013; 12:52-55.

Stollman TH, de Blaauw I, Wijnen MH, et al: Decreased mortality but increased morbidity in neonates with jejunoileal atresia; a study of 114 cases over a 34-year period. J Pediatr Surg 2009; 44: 217-221.

Shakya VC, Agrawal CS, Shrestha P, et al: Management of jejunoileal atresias: an experience at eastern Nepal. BMC Surg 2010; 10: 35.

Komuro H, Hori T, Amagai T, et al: The etiologic role of intrauterine volvulus and intussusception in jejunoileal atresia. J Pediatr Surg 2004; 39:1812-4.

Piper HG, Alesbury J, Waterford SD, et al: Intestinal atresias: factors affecting clinical outcomes. J Pediatr Surg 2008; 43:1244-8.

Shorter NA, Georges A, Perenyi A et al: A proposed classification system for familial intestinal atresia and its relevance to the understanding of the etiology of jejunoileal atresia. J Pediatr Surg 2006; 41:1822-5.

Alexander F, Babak D, Goske M. Use of intraluminal stents in multiple intestinal atresias. J Pediatr Surg 2002; 37:E34.

Elhalaby EA: Tube enterostomy in the management of intestinal atresia. Saudi Med J 2000; 21: 769-70.

Hung WT, Tsai YW, LU WT: T-Tube drainge for the treatment of high Jejunal atresia. J Pediatr Surg 1995; 30: 563-5.

Ozturk H, Gedik S, Duran H, et al: A comprehensive analysis of 51 Neonates with congenital intestinal Atresia. Saudi Med Journal 2007; 28: 1050-54.

Rescorla FJ, Grosfeld JL. Intestinal atresia and stenosis: analysis of survival in 120 cases. Surgery 1985; 98: 668-76.

Prasad TR, Bajpai M: Intestinal atresia. Indian J Pediatr 2000; 67:671-8.

Michal Blasczynski, Witold Porzucek, Piotr Becela, et al: T-tube enterostomy in surgical management of emergency cases in neonate. Archives of Perinatal Medicine 2011; 17(2), 93-96.

Rygl M, Pycha K, Stranak Z, et al: T-tube ileostomy for intestinal perforation in extremely low birth weight neonates. Pediatr SurgInt 2007; 23: 685-688.




DOI: https://doi.org/10.22037/irjps.v1i1.9866

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