Department of General Surgery, Karnataka, India.

Background An intestinal discontinuity caused by intestinal atresia is a congenital abnormality that may be associated with serious morbidity from intestinal failure. It is common for the bowel to be considerably dilated and dysfunctional close to the atresia. Resection with primary anastomosis or tapering enteroplasty with intestinal length preservation are two therapeutic options for this dilated colon. The goal of this study was to contrast these two methods in terms of bowel function as measured by the amount of time needed for a full enteral feeding. Methods Intestinal atresia repair procedures carried out at a tertiary referral paediatric hospital between 2007 and 2017 were retrospectively reviewed. Patients who underwent repair with tapering enteroplasty (n = 8) and were compared to those who underwent resection and anastomosis (n = 39) in terms of length of stay, time to complete enteral feeds, and complications. Results Between the two groups, there were similarities in the median age at operation, gender distribution, weeks gestational age (WGA), location of the atresia, and comorbidities. Overall, there was no statistically significant difference in any group's duration of stay or time to completion of enteral feedings. Due to intestinal dysmotility, five of 39 patients (13%; P = 0.12) in the nontapered group and three of eight (38%) patients in the tapered group needed additional surgical investigation. Abdominal reoperation and WGA were related with a longer length of hospital stay, while gastroschisis, WGA, and abdominal reoperation were associated with a longer time to complete enteral feedings. Conclusions When treating intestinal atresias, tapering enteroplasty retains gut length and, in terms of hospital stay and the time it takes to receive a full enteral feed, has statistically equal results to resection and anastomosis.

Intestinal atresia, Tapering enteroplasty

Arnav B Gupta. Is Cutting Enteroplasty a Better Option for Small Intestinal Atresia Than Resection of Dilated Bowel?. Insights Journal of Surgery and Clinical Case Reports 2020.