Pediatric surgery international · 2025
Factors influencing early surgical outcomes of intestinal atresia in a resource-limited tertiary center.
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Wassie Mesfin Tesera, Girma Samuel Mesfin, Gebru Fisseha Temesgen, Aklilu Woubedel Kiflu, Mammo Tihitena Negussie
Аннотация
BACKGROUND: Intestinal atresia is a congenital anomaly characterized by a complete obstruction of the intestinal lumen. This study aims to identify factors influencing outcomes in affected infants to inform targeted interventions and improve their care.
METHODS: This study employed a hybrid cohort design combining retrospective chart review with prospective data collection of patients surgically managed with intestinal atresia at a tertiary center over 5 years. Statistical analysis was performed using SPSS version 25.0, and p value of < 0.05 was considered statistically significant.
RESULTS: 82 patients with intestinal atresia were included; females comprised 61% (F:M ratio 1.56:1). The mean birth weight was 2499 ± 705 g, and the mean gestational age was 36.5 ± 2.5 weeks. Prenatal diagnosis was made in 23.2%, while 43.6% had associated anomalies. Intraoperatively, findings revealed obstruction in the duodenum (37.8%), jejunum (29.3%), ileum (29.3%), and colon (3.6%). Duodenal atresia was primarily managed with diamond-shaped duodenoduodenostomy (90.3%), while jejunal, ileal, and colonic atresia were managed with resection and anastomosis. Mortality was 42.7%, and sepsis (28.6%) and respiratory insufficiency (26%) were the leading causes of death. Prematurity was significantly associated as an independent risk factor for mortality.
CONCLUSION: Neonatal survival in our country remains poor compared to developed nations, with mortality influenced by premature deliveries, inefficient perioperative care, and postoperative complications.
METHODS: This study employed a hybrid cohort design combining retrospective chart review with prospective data collection of patients surgically managed with intestinal atresia at a tertiary center over 5 years. Statistical analysis was performed using SPSS version 25.0, and p value of < 0.05 was considered statistically significant.
RESULTS: 82 patients with intestinal atresia were included; females comprised 61% (F:M ratio 1.56:1). The mean birth weight was 2499 ± 705 g, and the mean gestational age was 36.5 ± 2.5 weeks. Prenatal diagnosis was made in 23.2%, while 43.6% had associated anomalies. Intraoperatively, findings revealed obstruction in the duodenum (37.8%), jejunum (29.3%), ileum (29.3%), and colon (3.6%). Duodenal atresia was primarily managed with diamond-shaped duodenoduodenostomy (90.3%), while jejunal, ileal, and colonic atresia were managed with resection and anastomosis. Mortality was 42.7%, and sepsis (28.6%) and respiratory insufficiency (26%) were the leading causes of death. Prematurity was significantly associated as an independent risk factor for mortality.
CONCLUSION: Neonatal survival in our country remains poor compared to developed nations, with mortality influenced by premature deliveries, inefficient perioperative care, and postoperative complications.