title: [Intraoperative placement of transnasal small intestinal feeding tube during the surgery in 5 cases with high position intestinal obstruction and postoperative feeding].
abstract: OBJECTIVE
  To explore the value of employing the small intestinal feeding tube in treating high position intestinal obstruction of newborn infant.
  
  
  METHODS
  Five newborn infants (3 males and 2 females; 1 premature infant and 4 fully-mature infants; 2 had membranous atresia of duodenum, 1 had annular pancreas, and 2 had proximal small intestine atresia; 1 infant had malrotation). The duodenal membrane-like atresia and the blind-end of small intestine were removed and intestinal anastomosis was performed, which was combined with intestinal malrotation removal. Before the intestinal anastomosis surgery, the anesthetist inserted via nose a 6Fr small intestinal ED tube, made by CREATE MEDIC CO LTD of Japan[
  
  
  BACKGROUND
  the State Food and Drug Administration-instrument (Im.) 2007-NO.2661620]. Twenty-four hours after surgery, abdominal X-ray plain film was taken and patients were fed with syrup; 48 hours later, formula milk was pumped or lactose-free milk amino acids were given by intravenous injection pump through the feeding tube. The amount of milk and fluids was gradually increased to normal amount according to the condition. In initial 3 days the intravenous nutrition was given and one week after operation, the infants were fed through mouth in addition to pumping milk through the tube and stopped infusion. Ten to 22 days after operation, the tube was removed and the infant patients were discharged.
  
  
  RESULTS
  All the five infants showed that the feeding through the nutrition tube was accomplished and the time of venous nutrition was reduced and fistula operation was avoided. None of the infants on question was off the tube and no jaundice exacerbation was found and the liver function was also found normal. At the very beginning, the tube was occasionally blocked by milk vale in one infant and after 0.9% sodium chloride solution flushing patency restored. After that, the feeding tube was washed once with warm water after feeding. In one infant vomiting occurred due to enough oral milk. The photograph of upper gastrointestine did not show anastomomotic stricture or fistula, or intestinal obstruction. After pulling out the tube, the symptoms disappeared and then the patient was discharged. One child was found to have diarrhea with no lactose nutrition liquid and given compound lactic bacteria preparations for oral administration, the symptom disappeared. In the 5 cases, the shortest hospital stay was 10 days and the longest was 22 days, the average stay was 16 days. Three to 5 days after operation the weight restored to birth weight, the weight had increased, when discharged, to an average of 5.5 g (kg·d).
  
  
  CONCLUSIONS
  The small intestinal feeding tube was very effective for the postoperative nutrition maintenance of high position intestinal obstruction in newborn infants.
authors.affiliation: Department of Pediatric Surgery and Anaesthesia, Rich Hospital of Nantong, Jiangsu, China.
authors.forename: Guang-qi
authors.initials: GQ
authors.lastname: Duan
authors.forename: Min
authors.initials: M
authors.lastname: Zhang
authors.forename: Xiao-hao
authors.initials: XH
authors.lastname: Guan
authors.forename: Zhi-qing
authors.initials: ZQ
authors.lastname: Yin
mesh_terms: D000714:Anastomosis, Surgical; D004750:Enteral Nutrition / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007409:Intestinal Atresia / Q000601:surgery; D007415:Intestinal Obstruction / Q000601:surgery*; D007421:Intestine, Small / Q000002:abnormalities / Q000601:surgery; D007441:Intubation, Gastrointestinal / Q000295:instrumentation / Q000379:methods*; D007902:Length of Stay; D008297:Male; D009666:Nose; D011182:Postoperative Care / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D015430:Weight Gain