40years’ review of intestinal atresia

Objective To analyze the 40 years' experience of intestinal atresia and to introduce a new design of longoblique anastomosis for disproportional loop s of the intestine Methods A total of 449 cases of congenital atresia of the small intesti ne were classified into three groups according to the embryopathology: high grou p (145 cases), including duodenal and high jejunal atresia; middle group (288), including ileojejunal atresia; and low group (16), including terminal ileal at resia To analyze the survival rate and mode of treatment, we assigned the cases into 3 gr oups according to the year of admission: 1) 1956-1969 (173 cases), under the gen eral pediatric surgical care; 2) 1970-1985 (147), under the specialty neonatal s urgical care; and 3) 1986-1996 (129), with additional use of total parenteral nu trition Results The ileojejunal atresia group (middle group) had the highest m ortality rate (476%) The overall mortality rate decreased as the time went b y, dropping from 647% in the early years down to 186% in the recent years, a nd no hospital death occurred in the recent couple of years Conclusion Besides the improvement of neonatal surgical techniques, sel ecting a proper surgical procedure according to the embryopathology is essential to the r eduction of mortality The longoblique anastomosis is particularly acceptable in China at present for marked disproportional loops