Journal of pediatric surgery · 2025
Postnatal Clinical Features and Surgical Strategies of Gastrointestinal Tract Duplications Diagnosed Prenatally.
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Wang Linyan, Zhang Shuhao, Wang Meiyan, Chen Yi, Qian Yunzhong, Chen Qingjiang, Gao Zhigang
Аннотация
BACKGROUND: There are few studies on systematic analysis of gastrointestinal tract (GIT) duplications diagnosed prenatally. This study aimed to investigate the postnatal clinical characteristics and surgical strategies of patients with GIT duplications diagnosed prenatally by analyzing the clinical data before and after delivery.
METHODS: A retrospective study was performed on the clinical data of GIT duplications diagnosed prenatally who underwent surgery at our hospital from January 2016 to December 2023. We classified the patients into two groups, the asymptomatic (66 cases) and symptomatic group (16 cases), and compared them.
RESULTS: A total of 82 patients were included. All cases were first prenatally diagnosed by ultrasound, with a median gestational age of 24 weeks, and 98.8 % of cases occurred in the second and third trimesters. The ileocecal region (50 %) was the most common site, followed by ileum, stomach, esophagus, duodenum, jejunum and colon. The median time of onset of symptoms was 0.6 months, with 56.3 % in the neonatal period. The complications included obstruction in 15 cases (93.8 %), infection in 3 cases (18.8 %) and perforation in 1 case (6.3 %). Thirty-eight (46.3 %) patients were complicated with other congenital anomalies, among which cardiac anomalies were the most common. The symptomatic group was treated earlier, the proportion of intraluminal type was higher, and the cyst diameter was significantly larger than the asymptomatic group. The proportion of open procedure was significantly higher in the symptomatic group, and the postoperative fasting time and hospital stay were longer. The incidence of complications and open procedure were higher in patients younger than 3 months.
CONCLUSION: Obstruction was the most common complication in prenatally diagnosed GIT duplication, and mostly occurred in neonatal period. Symptomatic patients need early intervention, asymptomatic patients can be closely observed and delayed resection, cyst diameter greater than 30 mm or intraluminal type can be considered early resection.
TYPE OF STUDY: Retrospective Comparative Study.
LEVEL OF EVIDENCE: Level III.
METHODS: A retrospective study was performed on the clinical data of GIT duplications diagnosed prenatally who underwent surgery at our hospital from January 2016 to December 2023. We classified the patients into two groups, the asymptomatic (66 cases) and symptomatic group (16 cases), and compared them.
RESULTS: A total of 82 patients were included. All cases were first prenatally diagnosed by ultrasound, with a median gestational age of 24 weeks, and 98.8 % of cases occurred in the second and third trimesters. The ileocecal region (50 %) was the most common site, followed by ileum, stomach, esophagus, duodenum, jejunum and colon. The median time of onset of symptoms was 0.6 months, with 56.3 % in the neonatal period. The complications included obstruction in 15 cases (93.8 %), infection in 3 cases (18.8 %) and perforation in 1 case (6.3 %). Thirty-eight (46.3 %) patients were complicated with other congenital anomalies, among which cardiac anomalies were the most common. The symptomatic group was treated earlier, the proportion of intraluminal type was higher, and the cyst diameter was significantly larger than the asymptomatic group. The proportion of open procedure was significantly higher in the symptomatic group, and the postoperative fasting time and hospital stay were longer. The incidence of complications and open procedure were higher in patients younger than 3 months.
CONCLUSION: Obstruction was the most common complication in prenatally diagnosed GIT duplication, and mostly occurred in neonatal period. Symptomatic patients need early intervention, asymptomatic patients can be closely observed and delayed resection, cyst diameter greater than 30 mm or intraluminal type can be considered early resection.
TYPE OF STUDY: Retrospective Comparative Study.
LEVEL OF EVIDENCE: Level III.