Laparoscope-assisted intestinal lengthening using an anterior flap in jejunal atresia.
BACKGROUND
Jejunal atresia with short bowel syndrome is an unusual type of jejunoileal atresia. They present with jejunal atresia near the ligament of Treitz and a foreshortened small bowel. In this paper, we report our preliminary experience to emphasize the advantages and feasibility of enteroplasty for intestinal lengthening and primary anastomosis with an anterior flap in jejunal atresia with short bowel syndrome in neonates.


METHODS
Between January 2014 and December 2014, four neonates with jejunal atresia and short bowel syndrome were submitted to this procedure in our hospital. Enteroplasty for intestinal lengthening procedures was accomplished in all the neonates by laparoscopic-assisted procedure. The procedure was manually performed after exteriorization of the atretic bowel via the slightly enlarged umbilical port site incision.


RESULTS
The mean operative time was 80 min (range 65-110 min). Blood loss was minimal. There was no mortality or surgical complication so far. The median follow-up duration was 14.5 months (range 9-20 months). In all the cases, the autonomy for oral/enteric feeding was obtained within 1 month after surgery. One neonate was readmitted because of associated cholestasis 1 month after the operation, and was cured by conservative therapy.


CONCLUSIONS
Enteroplasty for intestinal lengthening and primary anastomosis with an anterior flap is a safe and feasible technique that could allow increased tolerance to oral/enteric feeding, thereby improves their chances for quality survival.
Department of Pediatric Surgery, Huai'an Women and Children's Hospital, 104 Renmin Road South, Huai'an, 223002, Jiangsu, People's Republic of China. haalibing@126.com.
Bing
B
Li
Department of Pediatric Surgery, Huai'an Women and Children's Hospital, 104 Renmin Road South, Huai'an, 223002, Jiangsu, People's Republic of China.
Shun-lin
SL
Xia
Department of Pediatric Surgery, Huai'an Women and Children's Hospital, 104 Renmin Road South, Huai'an, 223002, Jiangsu, People's Republic of China.
Wei-bing
WB
Chen
Department of Pediatric Surgery, Huai'an Women and Children's Hospital, 104 Renmin Road South, Huai'an, 223002, Jiangsu, People's Republic of China.
Shou-qing
SQ
Wang
Department of General Surgery, Huai'an First People's Hospital, Nanjing Medical University, 6 Beijing Road West, Huai'an, 223300, Jiangsu, People's Republic of China.
Ye-bo
YB
Wang
D000714:Anastomosis, Surgical; D013505:Digestive System Surgical Procedures; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007409:Intestinal Atresia / Q000150:complications* / Q000601:surgery*; D007583:Jejunum / Q000601:surgery*; D020706:Laparoscopes; D010535:Laparoscopy; D008297:Male; D012778:Short Bowel Syndrome / Q000150:complications* / Q000601:surgery*; D013524:Surgical Flaps; D016896:Treatment Outcome
Intestinal atresia; Intestinal lengthening procedure; Laparoscopy; Neonate