Duodenal Derotation and Extent Tapering Jejunoplasty as Primary Repair for Neonates With High Jejunal Atresia
The dilated bowel segment usually involves the entire jejunum, as well as the duodenum in patients with high jejunal atresia. Classical approaches with a limited tapering enteroplasty and anastomosis frequently fail to restore intestinal function. A novel technique using duodenal derotation and exte...
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| Format: | Article |
| Language: | English |
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Elsevier
2010-10-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957210600526 |
| _version_ | 1818202065120264192 |
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| author | Chih-Cheng Luo Yung-Ching Ming Hsun-Chin Chao Shih-Ming Chu |
| author_facet | Chih-Cheng Luo Yung-Ching Ming Hsun-Chin Chao Shih-Ming Chu |
| author_sort | Chih-Cheng Luo |
| collection | DOAJ |
| description | The dilated bowel segment usually involves the entire jejunum, as well as the duodenum in patients with high jejunal atresia. Classical approaches with a limited tapering enteroplasty and anastomosis frequently fail to restore intestinal function. A novel technique using duodenal derotation and extent tapering jejunoplasty (DDETJ) is reported here.
Methods: Infants with high jejunal atresia within 10 cm of the ligament of Treitz treated with DDETJ over a 3-year period were reviewed. The entire dilated duodenum and jejunum were visualized after duodenal derotation. A longitudinal extensive tapering resection of dilated bowel with Endo GIA stapler was performed to fashion as a tube and anastomosed to the distal jejunum.
Results: Five female infants underwent this procedure over a 3-year period. Four infants underwent primary DDETJ, while one with associated multiple atresias had previously undergone limited tapering jejunoplasty, but was unable to tolerate oral feeding. DDETJ was performed 4 weeks later. There were no postoperative complications, and all patients tolerated feeding within 14 days. Follow-up lasted from 2 to 18 months.
Conclusion: In very proximal high atresia, the extent of tapering is limited by the proximity of the ligament of Treitz. Duodenal derotation provides better access to the high atresia. The results of this limited experience suggest that the DDETJ procedure could provide an alternative therapy in patients with high jejunal atresia. |
| first_indexed | 2024-12-12T03:03:31Z |
| format | Article |
| id | doaj.art-2480aab0e75d4b138e526ed289878559 |
| institution | Directory Open Access Journal |
| issn | 1875-9572 |
| language | English |
| last_indexed | 2024-12-12T03:03:31Z |
| publishDate | 2010-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj.art-2480aab0e75d4b138e526ed2898785592022-12-22T00:40:34ZengElsevierPediatrics and Neonatology1875-95722010-10-0151526927210.1016/S1875-9572(10)60052-6Duodenal Derotation and Extent Tapering Jejunoplasty as Primary Repair for Neonates With High Jejunal AtresiaChih-Cheng Luo0Yung-Ching Ming1Hsun-Chin Chao2Shih-Ming Chu3Department of Pediatric Surgery, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, TaiwanDepartment of Pediatric Surgery, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, TaiwanDivision of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, TaiwanDivision of Pediatric Neonatology, Department of Pediatrics, Chang Gung Children's Medical Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, TaiwanThe dilated bowel segment usually involves the entire jejunum, as well as the duodenum in patients with high jejunal atresia. Classical approaches with a limited tapering enteroplasty and anastomosis frequently fail to restore intestinal function. A novel technique using duodenal derotation and extent tapering jejunoplasty (DDETJ) is reported here. Methods: Infants with high jejunal atresia within 10 cm of the ligament of Treitz treated with DDETJ over a 3-year period were reviewed. The entire dilated duodenum and jejunum were visualized after duodenal derotation. A longitudinal extensive tapering resection of dilated bowel with Endo GIA stapler was performed to fashion as a tube and anastomosed to the distal jejunum. Results: Five female infants underwent this procedure over a 3-year period. Four infants underwent primary DDETJ, while one with associated multiple atresias had previously undergone limited tapering jejunoplasty, but was unable to tolerate oral feeding. DDETJ was performed 4 weeks later. There were no postoperative complications, and all patients tolerated feeding within 14 days. Follow-up lasted from 2 to 18 months. Conclusion: In very proximal high atresia, the extent of tapering is limited by the proximity of the ligament of Treitz. Duodenal derotation provides better access to the high atresia. The results of this limited experience suggest that the DDETJ procedure could provide an alternative therapy in patients with high jejunal atresia.http://www.sciencedirect.com/science/article/pii/S1875957210600526duodenal derotationextent tapering jejunoplastyhigh jejunal atresia |
| spellingShingle | Chih-Cheng Luo Yung-Ching Ming Hsun-Chin Chao Shih-Ming Chu Duodenal Derotation and Extent Tapering Jejunoplasty as Primary Repair for Neonates With High Jejunal Atresia Pediatrics and Neonatology duodenal derotation extent tapering jejunoplasty high jejunal atresia |
| title | Duodenal Derotation and Extent Tapering Jejunoplasty as Primary Repair for Neonates With High Jejunal Atresia |
| title_full | Duodenal Derotation and Extent Tapering Jejunoplasty as Primary Repair for Neonates With High Jejunal Atresia |
| title_fullStr | Duodenal Derotation and Extent Tapering Jejunoplasty as Primary Repair for Neonates With High Jejunal Atresia |
| title_full_unstemmed | Duodenal Derotation and Extent Tapering Jejunoplasty as Primary Repair for Neonates With High Jejunal Atresia |
| title_short | Duodenal Derotation and Extent Tapering Jejunoplasty as Primary Repair for Neonates With High Jejunal Atresia |
| title_sort | duodenal derotation and extent tapering jejunoplasty as primary repair for neonates with high jejunal atresia |
| topic | duodenal derotation extent tapering jejunoplasty high jejunal atresia |
| url | http://www.sciencedirect.com/science/article/pii/S1875957210600526 |
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