Factors influencing early surgical outcomes of intestinal atresia in a resource-limited tertiary center.

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.