title: Prolonged feeding difficulties after surgical correction of intestinal atresia: a 13-year experience.
abstract: BACKGROUND
  Although surgical interventions for intestinal atresia are usually successful, oral feed intolerance could raise in certain cases. The aim of this study was to identify the factors that affect postoperative oral feed by retrospective analysis.
  
  
  METHODS
  Neonates meeting the inclusion criteria, who were admitted at our center from 1 January 2000 to June 2013, were enrolled into this retrospective study. Time to establishment of full oral intake (TOI), length of hospital stay (LOS) were outcome measures. Univariate and multiple regression were used.
  
  
  RESULTS
  Overall survival was 85.7%. Mean TOI was 20.4 ± 17.8 days, and mean LOS was 35.6 ± 44.8 days. Multivariate analysis confirmed a significant association with TOI for meconium peritonitis (P=0.024), luminal discrepancy between proximal and distal intestine (P=0.038), number of anastomoses (P=0.044), reportage of immature ganglion in proximal and/or distal intestine (P=0.029), and short bowel syndrome (P<0.001). Prematurity (P=0.022) increased the duration of hospitalization without affecting time to full oral intake.
  
  
  CONCLUSIONS
  Meconium peritonitis, luminal discrepancy, number of anastomoses, reportage of immature ganglion, and short bowel syndrome were factors related to prolonged feeding difficulties. We advocate alertness for patients with these factors to reduce postoperative morbidity and treatment costs.
authors.affiliation: Department of Pediatric Surgery, Xinhua hospital, Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Shanghai, 200092, China; Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, No. 1665, Kongjiang Road, Shanghai, 200092, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Pediatric Surgery, Xinhua hospital, Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Shanghai, 200092, China; Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, No. 1665, Kongjiang Road, Shanghai, 200092, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Du
authors.affiliation: Department of Pediatric Surgery, Xinhua hospital, Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Shanghai, 200092, China; Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, No. 1665, Kongjiang Road, Shanghai, 200092, China. Electronic address: caiw1978@163.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Cai
authors.affiliation: Department of Pediatric Surgery, Xinhua hospital, Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Shanghai, 200092, China; Shanghai Key Laboratory of Pediatric Gastroenterology and Nutrition, No. 1665, Kongjiang Road, Shanghai, 200092, China.
authors.forename: Weihua
authors.initials: W
authors.lastname: Pan
authors.affiliation: Department of Pediatric Surgery, Xinhua hospital, Shanghai Jiao Tong University School of Medicine, No. 1665, Kongjiang Road, Shanghai, 200092, China.
authors.forename: Wenbo
authors.initials: W
authors.lastname: Yan
mesh_terms: D004750:Enteral Nutrition / Q000379:methods*; D005260:Female; D005544:Forecasting; D006801:Humans; D007231:Infant, Newborn; D007409:Intestinal Atresia / Q000601:surgery*; D008297:Male; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012778:Short Bowel Syndrome / Q000209:etiology / Q000628:therapy*
keywords: Intestinal atresia; Postoperative oral feeding; Predictive factors; Surgical intervention