Is the Bishop–Koop procedure useful in severe jejunoileal atresia?
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In brief
In brief
Retrospective study of 41 neonates with severe jejunoileal atresia treated via Bishop-Koop procedure at a Chinese tertiary center. Mortality was 7.3%, complication rate 41.4%, with nutritional status restored by stoma closure. Prematurity identified as primary risk factor for adverse outcomes.
Written by the GCMD Library team from the article.
Purpose
The aim of this study was to report our experience using the Bishop–Koop procedure for the treatment of various surgical problems of jejunoileal atresia including luminal discrepancy, complex meconium peritonitis, type IIIb and type IV atresia which we defined as severe jejunoileal atresia.
Methods
This retrospective study was performed on the patients with severe jejunoileal atresia who underwent Bishop–Koop procedure at a tertiary center in China over a five year of period. The mortality, complication rate, nutrition status and the risk factors for postoperative adverse outcomes were explored.
Results
A total of 41 neonates underwent the Bishop–Koop procedure. The median duration of the hospital stay and total parenteral nutrition and the point at which oral feeding was initiated postoperatively were 24 days (95% CI=18.99–29.01), 13 days (95% CI = 9.03–16.97) and 11 days (95% CI = 10.17–11.83) respectively. The mortality rate was 7.32% (3/41). The complication rate was 41.4% (17/41) including anastomotic leak, intestinal obstruction, high output stoma and cholestasis. The weight for age Z-score at stoma closure was restored to normal levels (−0.86, 95% confidence interval (CI) = −1.44, −0.28). The main factor associated with adverse outcomes in severe jejunoileal atresia was premature delivery (odds ratio (OR) = 4.44, 95% CI = 1.06–18.67).
Conclusions
Bishop–Koop procedure appears to be a technically efficient method for severe jejunoileal atresia, although larger studies are needed to compare Bishop–Koop procedure and other operation techniques.
Type of study
Therapeutic.
Level of evidence
Level IV.