256 Chapter 12 Abstract Purpose: No study has evaluated complication rates of the combined operations needed for temporary enterostomy compared to primary anastomosis in the treatment of jejunoileal atresia. Therefore the aim of this study is: 1) to compare the occurrence of severe postoperative complications (defined as Clavien-Dindo ≥III within 30 days) and 2) to compare the occurrence of different short- and long-term complications following treatment for jejunoileal atresia either by primary anastomosis or the combined enterostomy procedures. Methods: All consecutive neonates treated for jejunoileal atresias between January 1998 and February 2021 at our tertiary academic centres were retrospectively included. Perioperative characteristics and severity of postoperative complications (Clavien-Dindo) were extracted and evaluated, using chi-squared statistics, following each operation per treatment. Results: Eighty patients were included of whom 48 (60%) received a primary anastomosis and 32 (40%) an enterostomy. Perioperative baseline characteristics were comparable, apart from significantly more patients with a gastroschisis and significantly less patients with jejunum atresia in the enterostomy group. Our results showed that 1) significantly (p ≤ 0.01) more CD ≥III occur following treatment by enterostomy. 2) Both short-term (surgical site infection, wound dehiscence) and long-term (short bowel syndrome, adhesive bowel obstruction) complications occurred significantly more in those treated by enterostomy. We showed no significant difference in anastomotic leakage/stenosis and mortality rates between both treatment strategies. Conclusion: Although perioperative factors might necessitate an enterostomy, we advise a low threshold for performing a primary anastomosis when in doubt, taking into account the double risk of major complications found in patients treated with a temporary enterostomy.
RkJQdWJsaXNoZXIy MTk4NDMw