Is the Use of Transanastomotic Tube Beneficial in Pyloric Atresia?

Introduction: Congenital pyloric atresia (CPA) is a rare gastrointestinal system anomaly characterized by gastric outlet obstruction. This study evaluated patients operated for CPA in the past 15 years. The impact of use or non-use of transanastomotic feeding tubes (TATs) on the follow-up results was examined. Material and Method: Patients operated for CPA between 2005 and 2020 were evaluated. Further, cases in whom TATs were used and cases in whom TATs were not used were evaluated in two sub-groups. The impact of presence orabsence of TATs on postoperative follow-up results was examined. Results: In this study, a total of 12 patients consisting of 7 boys and 5 girls were evaluated. The mean birth week was 35.1 ± 2.4 (31-38) weeks and the mean birth weight was 2602.9 ± 599.6 (1680-3620) grams. The mean time of operation was postnatal 3.8 (1-10) days. Among the cases, 8 (66.7%) had type 1 atresia, and 4 (33.3%) had type 2 atresia. Heineke-Mikulicz pyloroplasty was performed on 9 (75%) cases, and gastroduodenostomy was performed on 3 (25%) cases. 4 (33.2%) patients had various additional anomalies. The patient with EB (8.3%) died due to sepsis in the early postoperative phase. In 8 cases (66.7%), intraoperative TAT placement was performed. In cases with TATs, the time to postoperative feeding and length of stay were statistically determined to be lower. Discussion: Pyloric atresia is a rare intestinal system obstruction. Comorbidity with congenital anomalies increases mortality. Intraoperative TAT insertion enables early enteral feeding. Keywors: Congenital pyloric atresia, gastrointestinal system, transanastomotic feeding tubes

[1]  N. Hall,et al.  Use of trans-anastomotic tubes in congenital duodenal obstruction. , 2022, Journal of pediatric surgery.

[2]  K. Bjørnland,et al.  Is postoperative transanastomotic feeding beneficial in neonates with congenital duodenal obstruction? , 2021, Pediatric Surgery International.

[3]  G. Prasad,et al.  Congenital Pyloric Atresia: Experience with a Series of 11 Cases and Collective Review , 2021, Journal of Indian Association of Pediatric Surgeons.

[4]  S. Ibuka,et al.  Prenatally diagnosed congenital pyloric atresia in consecutive three siblings: a case report , 2021, Surgical Case Reports.

[5]  R. Craigie,et al.  Transanastomotic tubes reduce the cost of nutritional support in neonates with congenital duodenal obstruction , 2018, Pediatric Surgery International.

[6]  K. Kishore,et al.  Congenital pyloric atresia - nine new cases: Single-center experience of the long-term follow-up and the lessons learnt over a decade. , 2018, Journal of pediatric surgery.

[7]  Weiwei Jiang,et al.  Early enteral nutrition for upper digestive tract malformation in neonate. , 2015, Asia Pacific journal of clinical nutrition.

[8]  F. Heinen Atresia de píloro. Comunicación de 3 casos , 2014 .

[9]  A. Al-Salem,et al.  Congenital pyloric atresia, presentation, management, and outcome: a report of 20 cases. , 2014, Journal of pediatric surgery.

[10]  J. Cama,et al.  Pyloric atresia in a healthy newborn – Two stage procedure , 2014 .

[11]  E. Choi,et al.  Case of Epidermolysis Bullosa with Pyloric Atresia , 2011, Annals of dermatology.

[12]  D. Burge,et al.  Trans-anastomotic tubes reduce the need for central venous access and parenteral nutrition in infants with congenital duodenal obstruction , 2011, Pediatric Surgery International.

[13]  M. Roček,et al.  Congenital Gastric Outlet Obstruction by Pyloric Membrane: Prenatal and Postnatal Diagnosis and Management , 2009, Fetal Diagnosis and Therapy.

[14]  A. Al-Salem,et al.  Congenital pyloric atresia and associated anomalies , 2007, Pediatric Surgery International.

[15]  V. Di Benedetto,et al.  Pyloric atresia: a new operation to reconstruct the pyloric sphincter. , 2004, Journal of pediatric surgery.

[16]  K. Narasimhan,et al.  Membranous pyloric atresia — local excision by a new technique , 1991, Pediatric Surgery International.

[17]  Z. İlçe,et al.  Pyloric atresia: 15-year review from a single institution. , 2003, Journal of pediatric surgery.

[18]  Y. Finkel,et al.  Transanastomotic feeding tube after an operation for duodenal atresia. , 2002, European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie.

[19]  A. Lander,et al.  Pyloric atresia: five new cases, a new association, and a review of the literature with guidelines. , 2000, Journal of pediatric surgery.

[20]  M. Mancini,et al.  Multiple gastrointestinal atresias with cystic dilatation of the biliary duct , 2000, Pediatric Surgery International.

[21]  B. Reichman,et al.  Aplasia cutis congenita associated with epidermolysis bullosa and pyloric atresia: The diagnostic role of prenatal ultrasonography , 1992, Prenatal diagnosis.

[22]  M. Hod,et al.  Prenatal diagnosis of familial congenital pyloric atresia , 1992, Prenatal diagnosis.

[23]  E. Adashi,et al.  An unusual case of epidermolysis bullosa hereditaria letalis with cutaneous scarring and pyloric atresia. , 1980, The Journal of pediatrics.

[24]  N. Bax,et al.  Congenital gastric outlet obstruction. , 1972, Acta paediatrica Belgica.