Lai Dengming,Tou Jinfa.Surgical treatment strategies of refractory intestinal atresia[J].Journal of Clinical Pediatric Surgery,,22():807-812.[doi:10.3760/cma.j.cn101785-202307011-002]
Surgical treatment strategies of refractory intestinal atresia
- Keywords:
- Intestinal Atresia; Surgical Procedures; Operative; Child; Patient Selection
- Abstract:
- Congenital intestinal atresia (CIA) is a common gastrointestinal malformation in neonates and surgery remains a sole option.With continuous improvements of diagnosis,anesthesia,monitoring and nutritional management,the survival of CIA patients keeps rising.However,managing refractory CIA is still a major challenge.No standardized treatment protocol is available for severe intestinal atresia.A variety of surgical modalities based upon Bishop-Koop or Santulli procedure may be selected.Resection,tapering enteroplasty,varus folding or elongation enteroplasty is indicated for dilated bowel.For promoting intestinal function recovery and early enteral nutrition,jejunal catheterization,transappendixal catheterization or transanal ileocecal drainage may be applied.For type IIIb atresia,a variety of mesangioplasty procedures are applied for retaining distal intestine.Continuous suturing under mucosa offers a better alignment of intestine and lowers the occurrence of anastomotic leakage.For CIA plus short bowel syndrome,supportive enteral parenteral nutrition is required for promoting intestinal adaptation.
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Memo
收稿日期:2023-7-5。
基金项目:国家自然科学基金(82171699);浙江省自然科学基金(Y22H049361)
通讯作者:钭金法,Email:toujinfa@zju.edu.cn