title: The role of parenteral nutrition following surgery for duodenal atresia or stenosis.
abstract: OBJECTIVE
  In our institution, some children routinely receive parenteral nutrition (PN) following surgery for duodenal atresia/stenosis, while others do not. Our aim was to compare growth and infection rate between these two treatment strategies.
  
  
  METHODS
  This was a retrospective study of all children undergoing surgery for duodenal atresia/stenosis over 7 years.
  
  
  RESULTS
  Of the 54 children, 19 commenced PN soon after surgery (the 'Initial PN' group). Of the remaining 35 children, 13 (37 %) subsequently required PN (the 'Delayed PN' group). The remaining 22 never received PN (the 'Never PN' group). The proportion of patients experiencing clinically suspected sepsis was higher in those receiving PN ('Initial' plus 'Delayed'; 41 %) compared with those who never received PN (14 %; p = 0.04). The 'Initial PN' and 'Never PN' groups did not show a significant change in weight Z score over time. However, the 'Delayed PN' group showed a significant decrease in weight Z scores from the time of operation to the time of achieving full enteral feeds, and failed to catch up by the time of last follow-up.
  
  
  CONCLUSIONS
  Children with duodenal atresia/stenosis can be managed without PN. However, a third of these children subsequently require PN, lose weight centiles, and have a high rate of sepsis.
authors.affiliation: Surgery Unit, Department of Paediatric Surgery, UCL Institute of Child Health and Great Ormond Street Hospital for Children, 30 Guilford Street, London, WC1N 1EH, UK.
authors.forename: M
authors.initials: M
authors.lastname: Bishay
authors.forename: B
authors.initials: B
authors.lastname: Lakshminarayanan
authors.forename: A
authors.initials: A
authors.lastname: Arnaud
authors.forename: M
authors.initials: M
authors.lastname: Garriboli
authors.forename: K M
authors.initials: KM
authors.lastname: Cross
authors.forename: J I
authors.initials: JI
authors.lastname: Curry
authors.forename: D
authors.initials: D
authors.lastname: Drake
authors.forename: E M
authors.initials: EM
authors.lastname: Kiely
authors.forename: P
authors.initials: P
authors.lastname: De Coppi
authors.forename: A
authors.initials: A
authors.lastname: Pierro
authors.forename: S
authors.initials: S
authors.lastname: Eaton
mesh_terms: D015331:Cohort Studies; D004380:Duodenal Obstruction / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007409:Intestinal Atresia; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010288:Parenteral Nutrition / Q000379:methods*; D011182:Postoperative Care / Q000379:methods*; D012189:Retrospective Studies; D018805:Sepsis / Q000150:complications; D015996:Survival Rate; D016896:Treatment Outcome