scholarly journals A comparative study of surgical procedures in neonatal intestinal atresia - resection and anastomosis, Bishop Koop, Santulli and Mikulicz procedure

2021 ◽  
Vol 8 (3) ◽  
pp. 495
Author(s):  
Aniruddha Basak
Keyword(s):  
Primary Anastomosis ◽  
Perioperative Period ◽  
Intestinal Atresia ◽  
Anastomosis Group ◽  
Nutrition Status ◽  
Group 4 ◽  
Jejunoileal Atresia ◽  
Operation Rate ◽  
Common Causes ◽  
Resection And Anastomosis

Background: The aim of this work was to assess the outcome for patients with jejunoileal atresia who underwent primary anastomosis, Bishop–Koop, Santulli procedure and Mikulicz procedure. Intestinal atresia is one of the most common causes of intestinal obstruction in neonates. But ideal surgical management of this condition remains controversial.Methods: During the period from January 2017 to January 2019, 112 neonates (62 males and 50 females) suspected to have intestinal atresia were operated in NRSMCH, Kolkata. 30 patients were treated with primary resection/ anastomosis, 30 patients underwent Bishop-koop (BK) technique, 27 patients who were treated with Santulli technique and 25 patients who were treated with Mikulicz procedure. Demographics, treatment and outcomes including mortality, morbidity and nutrition status were reviewed and were compared among the four groups.Results: 20 patients (17.86%) died during the perioperative period. Among them, 10 died due to uncontrolled sepsis and 10 due to malnutrition. Mortality was highest in Primary anastomosis group (33.33%) followed by BK group (13.3%), Santulli group (11.1%) and lowest in Mikulicz group (4%). The Mikulicz group experienced the lowest re-operation rate (4%) and Primary anastomosis group experienced highest re-operation (26.7%). This difference was statistically significant (P<0.003).Conclusions: Using Mikulicz procedure in the current study has improved the survival of these patients and minimized the post-operative complications.

scholarly journals Comparison of outcomes following three surgical techniques for patients with severe jejunoileal atresia

2019 ◽  
Vol 7 (6) ◽  
pp. 444-448
Author(s):  
Yan-Fen Peng ◽  
Hai-Qing Zheng ◽  
Hong Zhang ◽  
Qiu-Ming He ◽  
Zhe Wang ◽  
...  
Keyword(s):  
Complication Rate ◽  
Odds Ratio ◽  
Primary Anastomosis ◽  
Surgical Techniques ◽  
Total Mortality ◽  
Nutrition Status ◽  
Stoma Closure ◽  
Positive Correlation ◽  
Jejunoileal Atresia ◽  
Operation Rate

Abstract Background Severe jejunoileal atresia is associated with prolonged parenteral nutrition, higher mortality and secondary surgery. However, the ideal surgical management of this condition remains controversial. This study aimed to compare the outcomes of patients with severe jejunoileal atresia treated by three different procedures. Methods From January 2007 to December 2016, 105 neonates with severe jejunoileal atresia were retrospectively reviewed. Of these, 42 patients (40.0%) underwent the Bishop–Koop procedure (BK group), 49 (46.7%) underwent primary anastomosis (PA group) and 14 (13.3%) underwent Mikulicz double-barreled ileostomy (DB group). Demographics, treatment and outcomes including mortality, morbidity and nutrition status were reviewed and were compared among the three groups. Results The total mortality rate was 6.7%, showing no statistical difference among the three groups (P = 0.164). The BK group had the lowest post-operative complication rate (33.3% vs 65.3% for the PA group and 71.4% for the DB group, P = 0.003) and re-operation rate (4.8% vs 38.8% for the PA group and 14.3% for the DB group, P &lt; 0.001). Compared with the BK group, the PA group showed a positive correlation with the complication rate and re-operation rate, with an odds ratio of 4.15 [95% confidence interval (CI): 1.57, 10.96] and 12.78 (95% CI: 2.58, 63.29), respectively. The DB group showed a positive correlation with the complication rate when compared with the BK group, with an odds ratio of 7.73 (95% CI: 1.67, 35.72). The weight-for-age Z-score at stoma closure was –1.22 (95% CI: –1.91, –0.54) in the BK group and –2.84 (95% CI: –4.28, –1.40) in the DB group (P = 0.039). Conclusions The Bishop–Koop procedure for severe jejunoileal atresia had a low complication rate and re-operation rate, and the nutrition status at stoma closure was superior to double-barreled enterostomy. The Bishop–Koop procedure seems to be an appropriate choice for severe jejunoileal atresia.

scholarly journals Treatment of jejunoileal atresia by primary anastomosis or enterostomy: Double the operations, double the risk of complications

2021 ◽  
Author(s):  
Laurens D. Eeftinck Schattenkerk ◽  
Manouk Backes ◽  
Wouter J. de Jonge ◽  
LW Ernest van Heurn ◽  
Joep PM. Derikx
Keyword(s):  
Primary Anastomosis ◽  
Jejunoileal Atresia

Intrauterine Intussusception Presenting as Fetal Ascites and Meconium Peritonitis

2021 ◽  
Vol 5 (0-2) ◽  
pp. 18
Author(s):  
Khalilah Alhuda Binti Kamilen ◽  
Mohd Yusran Othman
Keyword(s):  
Primary Anastomosis ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Intestinal Atresia ◽  
Premature Baby ◽  
Abdominal Radiograph ◽  
Meconium Peritonitis ◽  
Ileal Perforation ◽  
Intraabdominal Sepsis ◽  
Intrauterine Intussusception

Intussusception is a well-known cause of intestinal obstruction in children. Its occurrence in fetus as an intrauterine incidence is extremely rare and poses a diagnostic difficulty. Intrauterine intussusception may result in intestinal atresia once the gangrenous segment resorbed. However, a very late occurrence of intussusception just prior to delivery may present as meconium peritonitis. We are reporting a case of premature baby who was born at 35 weeks gestation via emergency caesarean for breech in labour. Routine scan 4 days prior to the delivery showed evidence of fetal ascites. She was born with good Apgar Score and weighed 2.5kg. Subsequently she developed respiratory distress syndrome requiring mechanical ventilation. She passed minimal meconium once after birth then developed progressive abdominal distension and vomiting. Abdominal radiograph on day 4 of life revealed gross pneumoperitoneum and bedside percutaneous drain was inserted to ease the ventilation. Upon exploratory laparotomy, a single ileal perforation was seen 20cm from ileocecal junction with an intussusceptum was seen in the distal bowel. Gross meconium contamination and bowel edema did not favour the option of primary anastomosis, thus stoma was created. Reversal of stoma was performed a month later and she recovered well. Fetus with a complicated intrauterine intussusception may present with fetal ascites and their postnatal clinical and radiological findings need to be carefully assessed for evidence of meconium peritonitis; in which a timely surgical intervention is required to prevent the sequelae of prolonged intraabdominal sepsis in this premature baby.International Journal of Human and Health Sciences Supplementary Issue-2: 2021 Page: S18

scholarly journals A Minor Innovation in Constructing a Small Bowel Stoma in Neonates with Small Bowel Atresia to Reduce the Morbidity

2016 ◽  
Vol 5 (4) ◽  
pp. 45 ◽  
Author(s):  
Naeem Khan ◽  
Saba Bakht ◽  
Nadia Zaheer
Keyword(s):  
Small Bowel ◽  
Primary Anastomosis ◽  
Intestinal Atresia ◽  
Stoma Formation ◽  
New Type ◽  
Small Bowel Atresia ◽  
Bowel Atresia ◽  
A Minor ◽  
Lost To Follow Up

Background: Intestinal atresia has still significant morbidity in developing countries. Stomas are now not recommended in every case of intestinal atresia; primary anastomosis is the goal of surgery after resection of dilated adynamic gut. A new type of stoma formation along with primary anastomosis is being presented here.Materials and Methods: This report is based on our experience of many cases with this technique in last 12 years but all the details and long follow-up of each case is not available. However the method of surgical procedure, progress, complications, and advantages encountered have been highlighted.Results: Presently we have data of 7 patients; others are lost to follow up. Three had died with other associated problems, namely one with multiple atresias, two with septic shock and prematurity. Two stomas did not require formal closure because stoma shriveled and disappeared. Two other stomas had grown very long like a diverticulum when these were closed after 5 and 8 months.Conclusion: This technique is another attempt to decrease morbidity of patients of intestinal atresia especially in those cases where short bowel syndrome is feared after resection of proximal dilated gut.

Severity, Distribution, and Losses from Taproot Cankers Caused by Rhizoctonia solani in Peanuts1

1988 ◽  
Vol 15 (2) ◽  
pp. 73-75 ◽  
Author(s):  
John T. Turner ◽  
Paul A. Backman
Keyword(s):  
Rhizoctonia Solani ◽  
Surface Area ◽  
Disease Severity ◽  
Negative Correlation ◽  
Root Rot ◽  
High Frequency ◽  
Significant Negative Correlation ◽  
Anastomosis Group ◽  
Group 4

Abstract Research on the ecology of peanut roots from fields in Georgia, Florida, and Alabama revealed a high frequency of sunken, dark cankers on the taproot which persisted to harvest. Isolations from these cankers resulted in recovery of Rhizoctonia solani anastomosis group 4 (AG-4) from more than 50% of the cankers. A survey of peanut fields being harvested during early September revealed that 28% of the fields had an average of more than 50% of the taproot surface area cankered. In contrast, for fields in the same area harvested one month later, 77% had disease severities of less than 25% and none were greater than 50%. In an experiment conducted in 1984, roots from 64 plots were examined and rated for root rot severity and yield. When taproot disease severity was regressed against yield, a highly significant negative correlation (r2 − 0.60, P&lt;0.01) was found.

scholarly journals Differentiation of Three Homogeneous Groups of Rhizoctonia solani Anastomosis Group 4 by Analysis of Fatty Acids

2001 ◽  
Vol 91 (9) ◽  
pp. 821-830 ◽  
Author(s):  
Janell Stevens Johnk ◽  
Roger K. Jones
Keyword(s):  
Fatty Acids ◽  
Fatty Acid ◽  
Sugar Beet ◽  
North Dakota ◽  
Rhizoctonia Solani ◽  
Acid Methyl Ester ◽  
Anastomosis Group ◽  
Homogeneous Groups ◽  
Fame Analysis ◽  
Group 4

Profiles of fatty acids from 70 isolates of Rhizoctonia solani anastomosis group (AG)-4 clustered into three groups, corresponding to homogeneous group (HG)-I, HG-II, and a newly described HG-III. Isolates from Georgia peanuts exhibiting limb rot were characterized as gas chromatography (GC) subgroup 1 (GC-1) and contained HG-I isolates. Isolates from diseased soybean hypocotyls grown in North Dakota and sugar beet seedlings, taproots, and tare soil in Minnesota and North Dakota were characterized as GC subgroup 2 (GC-2) and contained predominantly HG-II isolates but also included three distinct isolates based on fatty acid methyl ester (FAME) analysis and morphological features. Selected isolates from North Carolina cucumbers clustered into three distinct groups that corresponded to HG-I, HG-II, and the newly described HG-III. Distinct isolates from the soybean and sugar beet populations clustered with HG-III. Fatty acid profiles of AG-4 were compared with FAME library profiles of AG-1, AG-2 type 2, and AG-3, which were developed in previous studies and were sufficiently different that they could be used to support speciation of this group from R. solani. It is suggested that binomial R. practicola may be appropriate for the portion of AG-4 identified as HG-II.

Apple-peel intestinal atresia: Enteroplasty for intestinal lengthening and primary anastomosis

2013 ◽  
Vol 48 (6) ◽  
pp. e5-e7 ◽  
Author(s):  
Luciano Silveira Onofre ◽  
Renato Frota de Albuquerque Maranhão ◽  
Elaine Cristina Soares Martins ◽  
Camila Girardi Fachin ◽  
Jose Luiz Martins
Keyword(s):  
Primary Anastomosis ◽  
Intestinal Atresia ◽  
Apple Peel ◽  
Intestinal Lengthening

scholarly journals Effect of Wirestem Severity on Survival and Head Production of Transplanted Broccoli and Cabbage

Plant Disease ◽  
2001 ◽  
Vol 85 (6) ◽  
pp. 639-643 ◽  
Author(s):  
Anthony P. Keinath ◽  
Mark W. Farnham
Keyword(s):  
Rhizoctonia Solani ◽  
Brassica Oleracea ◽  
Field Experiments ◽  
Anastomosis Group ◽  
Group 4 ◽  
Severity Levels ◽  
Highly Correlated ◽  
Field Plots

Field experiments were conducted with transplants of Brassica oleracea with known severity levels of wirestem caused by Rhizoctonia solani anastomosis group 4. Seedlings of broccoli and cabbage were grown in steamed soil infested with R. solani at 5 to 25 sclerotia/kg. Two weeks after inoculation, plants were separated into five severity classes based on wirestem symptoms, then transplanted into fumigated field plots in the spring and fall of 1995. The percentage of plants with and without aboveground symptoms was assessed at 14 and 42 days after transplanting. Marketable-sized heads were harvested eight times. In both seasons, percentages of symptomless plants, surviving (symptomless plus symptomatic) plants, and plants producing a marketable-sized head decreased as wirestem severity increased. Only 33 and 29% of cabbage transplants with >75% of the stem circumference girdled survived and produced a marketable head, respectively, compared with 95 and 83% of healthy transplants, respectively. For broccoli, only 15% of transplants with girdled stems survived and produced heads in spring but, in the fall, 74 and 72% of transplants with girdled stems survived and produced heads, respectively. Percentage of plants producing a marketable-sized head was highly correlated (P = 0.0001) with percentage of symptomless plants at 14 days after transplanting and percentage of surviving plants at 42 days after transplanting.

scholarly journals First-line tracheal resection and primary anastomosis for postintubation tracheal stenosis

2016 ◽  
Vol 98 (6) ◽  
pp. 425-430 ◽  
Author(s):  
H Elsayed ◽  
AM Mostafa ◽  
S Soliman ◽  
T Shoukry ◽  
AA El-Nori ◽  
...  
Keyword(s):  
Tracheal Stenosis ◽  
De Novo ◽  
Primary Anastomosis ◽  
Length Of Hospital Stay ◽  
Tracheal Resection ◽  
Endoscopic Dilation ◽  
First Line ◽  
Median Length ◽  
A Prospective Study ◽  
Resection And Anastomosis

Introduction Tracheal stenosis following intubation is the most common indication for tracheal resection and reconstruction. Endoscopic dilation is almost always associated with recurrence. This study investigated first-line surgical resection and anastomosis performed in fit patients presenting with postintubation tracheal stenosis. Methods Between February 2011 and November 2014, a prospective study was performed involving patients who underwent first-line tracheal resection and primary anastomosis after presenting with postintubation tracheal stenosis. Results A total of 30 patients (20 male) were operated on. The median age was 23.5 years (range: 13–77 years). Seventeen patients (56.7%) had had previous endoscopic tracheal dilation, four (13.3%) had had tracheal stents inserted prior to surgery and one (3.3%) had undergone previous tracheal resection. Nineteen patients (63.3%) had had a tracheostomy. Eight patients (26.7%) had had no previous tracheal interventions. The median time of intubation in those developing tracheal stenosis was 20.5 days (range: 0–45 days). The median length of hospital stay was 10.5 days (range: 7–21 days). The success rate for anastomoses was 96.7% (29/30). One patient needed a permanent tracheostomy. The in-hospital mortality rate was 3.3%: 1 patient died from a chest infection 21 days after surgery. There was no mortality or morbidity in the group undergoing first-line surgery for de novo tracheal lesions. Conclusions First-line tracheal resection with primary anastomosis is a safe option for the treatment of tracheal stenosis following intubation and obviates the need for repeated dilations. Endoscopic dilation should be reserved for those patients with significant co-morbidities or as a temporary measure in non-equipped centres.

scholarly journals Effects of Lornoxicam on Anastomotic Healing: A Randomized, Blinded, Placebo-Control Experimental Study

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Stamatoula Drakopoulou ◽  
Elissaios Kontis ◽  
Eirini Pantiora ◽  
Antonios Vezakis ◽  
Despoina Karandrea ◽  
...  
Keyword(s):  
Perioperative Period ◽  
Anastomotic Dehiscence ◽  
Multimodal Analgesia ◽  
Anastomosis Group ◽  
Anastomotic Healing ◽  
Placebo Control ◽  
Fisher Exact Test ◽  
Anastomotic Site ◽  
Opioid Use ◽  
Exact Test

Introduction and Aim. With the implementation of multimodal analgesia regimens, Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) are often administered for optimal pain control and reduction of opioid use. The aim of the study was to examine the effects of lornoxicam, a NSAID, on anastomotic healing employing an animal model.Materials and Methods. A total of 28 Wistar rats were randomly assigned in two groups. All animals underwent ascending colonic transection followed by an end-to-end hand sewn anastomosis. Group 1 received intraperitoneally lornoxicam before and daily after surgery. Group 2 received intraperitoneally an equal volume of placebo. Half of the animals in each group were euthanized on the 3rd pod and the remaining on the 7th pod. Macro- and microscopic indicators of anastomotic healing were compared using a two-tailed Fisher exact test.Results. The lornoxicam group significantly decreased fibroblast in growth and reepithelization of the mucosa at the anastomotic site on the 3rd pod and significantly increased occurrence of deep reaching defects, necrosis, and microabscess on the 7th pod.Conclusion. Lornoxicam administration during the perioperative period adversely affects histologic parameters of intestinal anastomotic healing. These effects of lornoxicam administration were not found to induce significant increase of anastomotic dehiscence in the rat model.

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