Comparison of outcomes between complete and incomplete congenital duodenal obstruction

Background: Congenital duodenal obstruction (CDO) can be complete (CCDO) or incomplete (ICDO). To date there is no outcome analysis available that compares both subtypes.
Aim: To quantify and compare the association bet
Background: Congenital duodenal obstruction (CDO) can be complete (CCDO) or incomplete (ICDO). To date there is no outcome analysis available that compares both subtypes.
Aim: To quantify and compare the association between CCDO and ICDO with outcome parameters.
Methods: We retrospectively reviewed all patients who underwent operative repair of CCDO or ICDO in our tertiary care institution between January 2004 and January 2017. The demographics, clinical presentation, preoperative diagnostics and postoperative outcomes of 50 patients were compared between CCDO (n = 27; atresia type 1-3, annular pancreas) and ICDO (n = 23; annular pancreas, web, Ladd´s bands).
Results: In total, 50 patients who underwent CDO repair were enrolled and followed for a median of 5.2 and 3.9 years (CCDO and ICDO, resp.). CCDO was associated with a significantly higher prenatal ultrasonographic detection rate (88% versus 4%; CCDO vs ICDO, P < 0.01), lower gestational age at birth, lower age and weight at operation, higher rate of associated congenital heart disease (CHD), more extensive preoperative radiologic diagnostics, higher morbidity according to Clavien-Dindo classification and comprehensive complication index (all P ≤ 0.01). The subgroup analysis of patients without CHD and prematurity showed a longer time from operation to the initiation of enteral feeds in the CCDO group (P < 0.01).
Conclusion: CCDO and ICDO differ with regard to prenatal detection rate, gestational age, age and weight at operation, rate of associated CHD, preoperative diagnostics and morbidity. The degree of CDO in mature patients without CHD influences the postoperative initiation of enteral feeding.
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Metadaten
Author:Stefan Gfrörer, Till-Martin Theilen, Henning C. Fiegel, Anoosh Esmaeili, Udo Rolle
URN:urn:nbn:de:hebis:30:3-508133
DOI:http://dx.doi.org/10.3748/wjg.v25.i28.3787
ISSN:2219-2840
ISSN:1007-9327
Pubmed Id:http://www.ncbi.nlm.nih.gov/pubmed?term=31391773
Parent Title (English):World journal of gastroenterology
Publisher:WJG Press
Place of publication:Beijing
Contributor(s):Yan-Liang Zhang, Yun-Xiaojian Wu
Document Type:Article
Language:English
Year of Completion:2019
Date of first Publication:2019/07/28
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2019/08/26
Tag:Adverse events; Clinical presentation; Congenital duodenal obstruction; Duodenal atresia; Duodenal stenosis; Outcome; Prenatal ultrasonographic detection rate; Preoperative diagnostics
Volume:25
Issue:28
Pagenumber:16
First Page:3787
Last Page:3797
Note:
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licen ses/by-nc/4.0/
HeBIS PPN:453774784
Institutes:Medizin
Dewey Decimal Classification:610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (English):License LogoCreative Commons - Namensnennung-Nicht kommerziell 4.0

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