258 Chapter 12 used a twostep extraction method to include all eligible patients based on: 1) ICD-codes for jejunoileal atresia and 2) operation codes for jejunoileal atresia. Ethical approval was received by the local medical ethical commission (reference: W18_233#18.278). All patients were checked manually for eligibility by two medical doctors (LES & MB). Data were retrieved and stored in the online database Castor EDC (13). Outcome definitions The jejunoileal atresias were classified using the modified Martin-Zerella classification by Stollman (5, 14). Atresias were grouped as type 0 (membrane only), type I (atresia with continuity of bowel wall), type II (discontinuity of bowel wall attached by cord), type IIIA (discontinuity of bowel wall, disconnected with mesenteric defect), type IIIB (apple peel atresia), Type IV (multiple atresias). The atresias were classified using both surgical and pathology reports. Patient characteristics collected included sex, history of prematurity (gestational age < 37 weeks), birthweight, low birthweight (defined as ≤ 2500 gram following WHO guidelines(15)), age at time of surgery, American Society of Anaesthesiology (ASA) score at time of primary surgery, location and type of atresia, significant comorbidities (gastroschisis, omphalocele, volvulus, malrotation, Meckel diverticula, cystic fibrosis, meconium ileus) as described in the patient file. Surgical characteristics were duration of surgery (for each procedure: primary anastomosis, enterostomy formation and reversal), the number of anastomoses created during primary surgery and centimetres of small intestine resected at primary surgery (as measured in the surgical or pathology reports). Postoperative characteristics were hospital admission, length of follow-up and in case of performing an enterostomy the number of days between creation and reversal. The primary outcome was the difference in occurrence of severe complications following either primary anastomosis or the combined enterostomy procedures. Complications in the first thirty days following surgery were analysed and scored using the ClavienDindo classification (Grade I: Any deviation from the normal postoperative course without the need for intervention; Grade II: Requiring pharmacological treatment such as antibiotics, blood transfusions and total parenteral nutrition; Grade III: Requiring surgical, endoscopic or radiological intervention; Grade IV: Life-threatening complication requiring NICU-management; Grade V: Death of a patient) (16). A severe complication was defined as Clavien-Dindo III or higher. The incidence of complications during either enterostomy formation or reversal were combined as to be able to compare the
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