261 Treatment of jejunoileal atresia by primary anastomosis or enterostomy Chapter 12 (p = 0.03) and short bowel syndrome (p =0.03) were the late complications that occurred significantly more often as well in the enterostomy group, whilst there was no significant difference in the occurrence of anastomotic leakage (F = 1) and stenosis (p = 0.19). A sensitivity analysis, excluding all gastroschisis patients, resulted in non-significant differences between the two treatment groups for Clavien-Dindo ≥III complications, adhesive bowel obstruction and short bowel syndrome, whilst surgical site infection and wound dehiscence stayed significant Anastomotic leakage occurred in four (9%) patients following primary anastomosis and three patients (10%) experienced leakage following enterostomy reversal, which did not result in death. An anastomotic stenosis occurred in eight patients for both primary anastomosis (17%) and enterostomy reversal (25%). Of the three patients who also received an anastomosis during enterostomy formation, one (33%) developed an anastomotic stenosis. Furthermore, an adhesive obstruction resulting in surgery occurred in four (8%) patients with primary anastomosis and in eight (25%) patients following enterostomy reversal. Finally, enterostomy related complications were common. A highoutput enterostomy was reported in 15 (48%) of the patients. Enterostomy revision was performed in nine cases (29%) and early closure due to an enterostomy associated complication (stenosis (1x), ischemia (4x), prolapse (1x)) in six (19%). Other enterostomy related complications resulting in redo surgery were ischemia (2x), leakage causing peritonitis, perforation and parastomal hernia. Causes of mortality Five patients died following treatment (Table 1), all of which were prematurely born and suffered comorbidities. From those that died following primary enterostomy, one died one day following surgery due to intra vascular haemorrhage and cerebral hypoxia which was presumed to have occurred intra-uterine. The other two were both patients with a gastroschisis that died as a result of postoperative complications following enterostomy reversal. One died because of sepsis and multiorgan failure following a duodenum perforation caused by an adhesive stenosis. The other suffered from hemodynamic instability due to sepsis and blood loss following enterostomy reversal. It was presumed this led to an intraabdominal bleeding, but the patient was deemed unfit for surgery and no autopsy was performed.
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