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INTESTINAL ATRESIA: FACTORS AFFECTING SURVIVAL
Author(s) -
Smith GrahameH. H.,
Glasson Martin
Publication year - 1989
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1989.tb01487.x
Subject(s) - medicine , anastomosis , stoma (medicine) , atresia , intestinal atresia , surgery , mortality rate , gastroenterology , ileum
Eighty‐four patients with congenital jejuno‐ileal or colonic atresia treated at this hospital during the years 1961–86 were studied. There were 42 cases of jejunal atresia, seven cases of jejuno‐ileal atresia, 33 cases of ileal atresia and two cases of colonic atresia. Multiple atresias occurred in 19 patients. During the first 15 years of the study the mortality rate was 56%. In the last 10 years it was 22%. Multivariate linear modelling techniques were used to determine the factors associated with a fatal outcome. In order of magnitude associations were found between death and year of treatment ( p < 0.01), the type of anastomosis performed to correct the atresis ( p < 0.05), the presence of other congenital abnormalities ( p < 0.01) and presence of a malrotation ( p < 0.02). The anastomoses associated with the highest mortality were those with a stoma. The mean length of bowel resected proximal to the anastomosis was 15cm and the mean length resected distally 5 cm. Eleven patients had 60cm or less of small bowel remaining after surgery and only three of these survived. The highest mortality rate can be expected in patients with other congenital abnormalities and those with a malrotation. A primary anastomosis without a stoma is recommended.