JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE) ›› 2021, Vol. 41 ›› Issue (9): 1162-1168.doi: 10.3969/j.issn.1674-8115.2021.09.005

• Neonatal surgery topics • Previous Articles    

Laparoscopic diagnosis and treatment of high jejunal atresia and stenosis in neonates

Bao-hong ZHAO(), Hong-xia REN(), Xiao-xia WU, Yuan-yuan JIN, Wen-yue LIU, Liang ZHAO, Hui ZHANG, Xin GUO, Xue SUN   

  1. Department of Neonatal Surgery, Children′s Hospital of Shanxi Province, Taiyuan 030025, China
  • Received:2021-03-08 Online:2021-08-24 Published:2021-08-24
  • Contact: Hong-xia REN E-mail:zhaobaohong2008@163.com;renhongxia100@sina.com

Abstract: Objective

·To investigate the effect of laparoscope on the treatment of high jejunal atresia and stenosis in neonates.

Methods

·From January 2009 to December 2019, 90 neonates with high jejunal atresia and stenosis were operated on Children′s Hospital of Shanxi province. According to whether laparoscopic surgery was used or not, they were divided into laparoscopic group (n=66) and laparotomy group (n=24). In the laparoscopic group, 27 cases of type Ⅰ atresia and stenosis less than 10 cm from Treitz ligament were anastomosed under laparoscopy, and 39 cases of jejunal atresia and stenosis 10?30 cm from the Treitz ligament, underwent extraperitoneal anastomosis by expanded trocar hole with the aid of single-site laparoscope. Traditional laparotomy exploratory incision was used in the laparotomy group. The operation time, the first postoperative oral feeding time, postoperative full oral feeding time [postoperative oral feeding volume reaching 150 mL/(kg·d)], the length of hospital stay, and mortality and incidence of complications were compared between the two groups.

Results

·There was no significant difference between the laparoscopic group and laparotomy group in age, gender, weight, premature infant, low birth weight, other systems malformation and pathological type. There was no significant difference in operation time between the laparoscopic group and laparotomy group [(77.0±24.0) min vs (82.0±24.0) min]. The first postoperative oral feeding time, postoperative full oral feeding time [postoperative oral feeding volume reaching 150 mL/(kg·d)], and the length of hospital stay in the laparoscopic group were shorter than those in the laparotomy group [(13.3±7.2) d, (19.1±8.1) d, (22.1±8.5) d vs (17.2±7.8) d,(23.7±10.6) d, (27.0±11.8) d, all P <0.05]. There was no significant difference between the laparoscopic group and laparotomy group in mortality (1/66 vs 2/24) and incidence of complications (7/66 vs 6/24).

Conclusion

·Laparoscopic surgery is a safe and effective method in the diagnosis and treatment of neonatal high jejunal atresia/stenosis.

Key words: laparoscope, jejunal atresia, neonate

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