Duodenal Atresia Repair: A Single-Center Comparative Study.

Creator(s)

Nelimar Cruz-Centeno, Children's Mercy Kansas City
Shai Stewart, Children's Mercy Kansas City
Derek R. Marlor, Children's Mercy Kansas CityFollow
Pablo Aguayo, Children's Mercy HospitalFollow
Rebecca M. Rentea, Children's Mercy HospitalFollow
Richard J. Hendrickson, Children's Mercy HospitalFollow
David Juang, Children's Mercy HospitalFollow
Charles L. Snyder, Children's Mercy HospitalFollow
Jason D. Fraser, Children's Mercy HospitalFollow
Shawn D. St Peter, Children's Mercy HospitalFollow
Tolulope A. Oyetunji MD MPH, Children's Mercy Kansas CityFollow

Document Type

Article

Publication Date

12-2023

Identifier

DOI: 10.1177/00031348231180910

Abstract

BACKGROUND: The use of laparoscopy in the repair of duodenal atresia has been increasing. However, there is no consensus regarding which surgical approach has better outcomes. We aimed to compare the different surgical approaches and types of anastomoses for duodenal atresia repair.

METHODS: Patients who underwent duodenal atresia repair at a single pediatric center were identified between January 2006 and June 2022. Those with concomitant gastrointestinal anomalies or who required other simultaneous operations were excluded. The primary outcome was rate of complications, defined as rate of leak, stricture, and re-operation by surgical approach and technique of anastomosis.

RESULTS: A total of 78 patients were included. The majority were female (51.3%, n = 40), with a median age of 4 days (IQR 3.0,8.0) and a median weight of 2.7 kg (IQR 2.2,3.3) at repair. The re-operation rate was 7.7% (n = 6), of which two were anastomotic leaks, and four were anastomotic strictures. The leak rate was 5.6% (n = 1/18) for the open handsewn and 4.8% (n = 1/21) for the laparoscopic handsewn technique. The stricture rate was 12.5% (n = 1/8) for the laparoscopic-assisted handsewn, 9.1% (n = 2/22) for the laparoscopic U-clip, 4.8% (n = 1/21) for the laparoscopic handsewn, and none with laparoscopic stapled and laparoscopic converted to open handsewn techniques. No differences were found in complication rate when controlling for surgical approach.

CONCLUSION: The method of surgical approach did not affect the outcomes or complications in the repair of duodenal atresia.

Journal Title

The American surgeon

Volume

89

Issue

12

First Page

5911

Last Page

5914

MeSH Keywords

Child; Humans; Male; Female; Constriction, Pathologic; Retrospective Studies; Duodenal Obstruction; Intestinal Atresia; Anastomotic Leak; Anastomosis, Surgical; Treatment Outcome; Postoperative Complications

Keywords

anastomosis; duodenal atresia; laparoscopy; outcomes; surgical technique

Recommended Citation

Cruz-Centeno N, Stewart S, Marlor DR, et al. Duodenal Atresia Repair: A Single-Center Comparative Study. Am Surg. 2023;89(12):5911-5914. doi:10.1177/00031348231180910