Etensel Barlas, Temir Günyüz, Karkiner Aytaç, Melek Mehmet, Edirne Yeşim, Karaca Irfan, Mir Erol
Department of Pediatric Surgery, Adnan Menderes University, 09100 Aydin, Turkey.
J Pediatr Surg. 2005 Aug;40(8):1258-68. doi: 10.1016/j.jpedsurg.2005.05.008.
BACKGROUND/PURPOSE: Colonic atresia (CA) is one of the rarest causes of neonatal intestinal obstructions, and no large series can be reported. Therefore, we did perform a retrospective clinical trial to delineate our CA cases and carry out a literature survey.
We reviewed the charts of CA cases treated in our center between 1992 and 2002. We aimed to collect all reported cases in Medline, and personal communications with the authors of published series were used to reach the missing data.
The chart review revealed 9 newborns with CA treated in our center (6 cases of type III, 2 cases of type II, and 1 case of type IV). These accounted for 3.7% of all gastrointestinal atresias managed in our center. Of the CA cases, 3 were isolated and 6 had at least one or more associated congenital anomalies. The preferred surgical technique at the initial treatment of CA was performing a proximal stoma and distal mucous fistula in an average of postnatal 59.4 hours. The literature survey enabled us to reach 224 cases of CA, including our cases.
Because of the low incidence of CA, delay in diagnosis and treatment may occur. The mortality is statistically higher when the surgical management is performed after 72 hours of age. However, the prognosis of CA is satisfactory if diagnosis and surgical management could be made promptly and properly.
背景/目的：结肠闭锁（CA）是新生儿肠梗阻最罕见的病因之一，尚无大量病例系列报道。因此，我们开展了一项回顾性临床试验，以描述我们中心的CA病例并进行文献调查。
我们回顾了1992年至2002年在我们中心接受治疗的CA病例的病历。我们旨在收集Medline中所有已报道的病例，并通过与已发表系列文章的作者进行个人交流来获取缺失数据。
病历回顾显示，我们中心有9例新生儿患有CA（III型6例，II型2例，IV型1例）。这些病例占我们中心所有胃肠道闭锁病例的3.7%。在CA病例中，3例为孤立性，6例至少有一个或多个相关先天性异常。CA初始治疗时首选的手术技术是在出生后平均59.4小时行近端造口术和远端黏液瘘。文献调查使我们能够收集到包括我们病例在内的224例CA病例。
由于CA发病率低，可能会出现诊断和治疗延迟。若在72小时龄后进行手术治疗，死亡率在统计学上更高。然而，如果能及时、正确地进行诊断和手术治疗，CA的预后是令人满意的。
