BACKGROUND Congenital intestinal atresia(CIA)is a common intestinal malformation in the neonatal period,and surgery is currently the main treatment method.The choice of postoperative feeding is crucial for the recover...BACKGROUND Congenital intestinal atresia(CIA)is a common intestinal malformation in the neonatal period,and surgery is currently the main treatment method.The choice of postoperative feeding is crucial for the recovery of gastrointestinal function in children.AIM To compare and analyze the effects of different postoperative feeding methods on gastrointestinal function reconstruction in newborns with CIA.METHODS Twenty-six children diagnosed with neonatal CIA,treated with minimally invasive surgery at Shijiazhuang Maternal and Child Health Hospital between January 2021 and May 2024,were selected for this single-center prospective randomized controlled study.They were divided into two groups using envelope randomization:Enteral nutrition(EN)group(n=13)and parenteral nutrition(PN)group(n=13).Baseline and clinical characteristics were collected,and recovery time of bowel sounds and time to first defecation were used as evaluation indices for gastrointestinal functional reconstruction.Differences between the groups were analyzed using t-test,χ2 test,and Fisher’s exact test.Spearman’s correlation tests and linear regression models were employed to analyze factors influencing time to first defecation.RESULTS The time to bowel sound recovery(51.54 vs 65.85,P=0.013)and first defecation(58.15 vs 76.62,P<0.001)was shorter in the EN group compared to the PN group.Clinical improvements in the EN group,including discharge weight(P=0.044),hospital stay(P=0.027),white blood cell count(P=0.023),albumin content(P=0.013),and direct bilirubin content(P=0.018),were also better than those in the PN group.No substantial differences in postoperative complications were found between the groups.Correlation analysis indicated that abdominal infection and operation time may relate to time to first defecation.Linear regression analysis demonstrated a considerable association between EN feeding and shorter time to first defecation.Abdominal infection and an operation time>2 hours may be risk factors for prolonged time to first defecation.CONCLUSION EN substantially promotes the recovery of gastrointestinal function after CIA in neonates and can improve clinical outcomes in children.Future research should explore optimal EN practices to enhance clinical application and child health.展开更多
Objective To analyze the 40 years' experience of intestinal atresia and to introduce a new design of longoblique anastomosis for disproportional loop s of the intestine Methods A total of 449 cases of congenital...Objective To analyze the 40 years' experience of intestinal atresia and to introduce a new design of longoblique anastomosis for disproportional loop s of the intestine Methods A total of 449 cases of congenital atresia of the small intesti ne were classified into three groups according to the embryopathology: high grou p (145 cases), including duodenal and high jejunal atresia; middle group (288), including ileojejunal atresia; and low group (16), including terminal ileal at resia To analyze the survival rate and mode of treatment, we assigned the cases into 3 gr oups according to the year of admission: 1) 1956-1969 (173 cases), under the gen eral pediatric surgical care; 2) 1970-1985 (147), under the specialty neonatal s urgical care; and 3) 1986-1996 (129), with additional use of total parenteral nu trition Results The ileojejunal atresia group (middle group) had the highest m ortality rate (476%) The overall mortality rate decreased as the time went b y, dropping from 647% in the early years down to 186% in the recent years, a nd no hospital death occurred in the recent couple of years Conclusion Besides the improvement of neonatal surgical techniques, sel ecting a proper surgical procedure according to the embryopathology is essential to the r eduction of mortality The longoblique anastomosis is particularly acceptable in China at present for marked disproportional loops展开更多
文摘BACKGROUND Congenital intestinal atresia(CIA)is a common intestinal malformation in the neonatal period,and surgery is currently the main treatment method.The choice of postoperative feeding is crucial for the recovery of gastrointestinal function in children.AIM To compare and analyze the effects of different postoperative feeding methods on gastrointestinal function reconstruction in newborns with CIA.METHODS Twenty-six children diagnosed with neonatal CIA,treated with minimally invasive surgery at Shijiazhuang Maternal and Child Health Hospital between January 2021 and May 2024,were selected for this single-center prospective randomized controlled study.They were divided into two groups using envelope randomization:Enteral nutrition(EN)group(n=13)and parenteral nutrition(PN)group(n=13).Baseline and clinical characteristics were collected,and recovery time of bowel sounds and time to first defecation were used as evaluation indices for gastrointestinal functional reconstruction.Differences between the groups were analyzed using t-test,χ2 test,and Fisher’s exact test.Spearman’s correlation tests and linear regression models were employed to analyze factors influencing time to first defecation.RESULTS The time to bowel sound recovery(51.54 vs 65.85,P=0.013)and first defecation(58.15 vs 76.62,P<0.001)was shorter in the EN group compared to the PN group.Clinical improvements in the EN group,including discharge weight(P=0.044),hospital stay(P=0.027),white blood cell count(P=0.023),albumin content(P=0.013),and direct bilirubin content(P=0.018),were also better than those in the PN group.No substantial differences in postoperative complications were found between the groups.Correlation analysis indicated that abdominal infection and operation time may relate to time to first defecation.Linear regression analysis demonstrated a considerable association between EN feeding and shorter time to first defecation.Abdominal infection and an operation time>2 hours may be risk factors for prolonged time to first defecation.CONCLUSION EN substantially promotes the recovery of gastrointestinal function after CIA in neonates and can improve clinical outcomes in children.Future research should explore optimal EN practices to enhance clinical application and child health.
文摘Objective To analyze the 40 years' experience of intestinal atresia and to introduce a new design of longoblique anastomosis for disproportional loop s of the intestine Methods A total of 449 cases of congenital atresia of the small intesti ne were classified into three groups according to the embryopathology: high grou p (145 cases), including duodenal and high jejunal atresia; middle group (288), including ileojejunal atresia; and low group (16), including terminal ileal at resia To analyze the survival rate and mode of treatment, we assigned the cases into 3 gr oups according to the year of admission: 1) 1956-1969 (173 cases), under the gen eral pediatric surgical care; 2) 1970-1985 (147), under the specialty neonatal s urgical care; and 3) 1986-1996 (129), with additional use of total parenteral nu trition Results The ileojejunal atresia group (middle group) had the highest m ortality rate (476%) The overall mortality rate decreased as the time went b y, dropping from 647% in the early years down to 186% in the recent years, a nd no hospital death occurred in the recent couple of years Conclusion Besides the improvement of neonatal surgical techniques, sel ecting a proper surgical procedure according to the embryopathology is essential to the r eduction of mortality The longoblique anastomosis is particularly acceptable in China at present for marked disproportional loops
