259 Treatment of jejunoileal atresia by primary anastomosis or enterostomy Chapter 12 occurrence to primary anastomosis. A complication was counted if it occurred during either one or both operations. Secondary outcome were the different short term (within 30 days following surgery) and long-term (during follow up) complications. The following complications were addressed: mortality, surgical site infections, central venous catheter infections, necrotizing enterocolitis, cholestasis, short-bowel syndrome, anastomotic leakage, anastomotic stenosis, adhesive bowel obstruction, incisional hernia and enterostomy complications. Surgical site infections were classified following the definition for superficial site infection from the US Centre of Disease Control and Prevention (CDC) (17). Central venous catheter infections were only scored if either blood culture confirmed or clinical suspicion leading to intravenous antibiotic treatment or line removal. Clinical suspicion alone without subsequent treatment or redness at sight without a positive blood culture was not scored as an infection. Necrotizing enterocolitis was classified as a complication with at least Bell’s stage IIB (pneumatosis visible on abdominal radiograph) (18). Cholestasis was defined as conjugated serum bilirubin greater than or equal to 2 mg/ dL, we did not differentiate between causes of cholestasis (19). Short bowel syndrome was defined as the need for total parenteral nutrition ≥ 60 days following enterostomy or primary anastomosis creation (20). Anastomotic leakage was defined by findings of anastomotic leakage during redo surgery or when confirmed by an ultrasound performed by a specialized paediatric radiologist. Anastomotic stenosis was defined by a stenosis at the anastomotic sight observed during redo surgery or confirmed by contrast enema. An adhesive obstruction was defined by a stenosis caused by an adhesion observed during redo surgery. Incisional hernia was defined as a fascial defect at the sight of incision resulting in redo surgery, cases that resolved without redo surgery were not included. High output enterostomy was defined as an enterostomy-output of ≥ 20ml/kg per 24 hours (21). Need for early closure of the enterostomy was documented. An enterostomy prolapse was registered when noted in the patient file. Statistical analysis Continuous variables were assessed for normality by evaluating histograms. In the case of normally distributed data the continuous outcomes were presented using the mean and standard deviation (std). For non-normally distributed outcomes the median and interquartile range (IQR) between the 25th and 75th percentile were used. Outcomes were compared using one-way ANOVA or T-test for normally distributed data and MannWhitney U test for non-normally distributed data. Categorical data were presented as numbers with percentages and were compared using the x²-test (P=…) or Fisher’s exact test (F=…) if applicable.
RkJQdWJsaXNoZXIy MTk4NDMw