Neonatal intestinal obstruction: Reducing short-term complications by surgical refinements

P. Bagolan, S. Nappo, A. Trucchi, F. Ferro, A. Alessandri

Research output: Contribution to journalArticle

Abstract

Over the last ten years advances in neonatal intensive care, such as the advent of parenteral nutrition, have led to a significant decrease in the mortality rates of neonates with intestinal obstruction. Nevertheless, surgical short-term complications associated with the intestinal anastomosis performed, such as stenosis or leakage, and long-term nutritional complications due to extensive resections are still responsible for mortality and for a high morbidity rate. 39 newborns referred to our hospital in the past 3 years for intestinal obstruction were retrospectively evaluated with particular attention to the surgical management, surgical techniques and subsequent complications. Age on admission was from 1 hour to 24 days; weight from 1.4 to 3.8 kg; 41% of newborns had a prenatal diagnosis, 57 surgical procedures were performed: among them 44 intestinal anastomoses. Short-term surgical complications, namely perforation and stenosis, were observed in 18.1% of anastomoses. The complication rate after simple end-to-end anastomosis was as high as 30%. However, certain technical refinements such as tailoring the dilated upper pouch, positioning a transanastomotic feeding tube and an intubated lateral stoma resulted in a much lower complication rate (3.7%). Thus, in our experience these technical refinements are effective in reducing the incidence of short-term surgical complications.

Original languageEnglish
Pages (from-to)354-357
Number of pages4
JournalEuropean Journal of Pediatric Surgery
Volume6
Issue number6
Publication statusPublished - Dec 1996

Keywords

  • intestinal obstruction
  • neonatal surgery
  • short-bowel syndrome

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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