Peng Yanfen, Zheng Haiqing, He Qiuming, Wang Zhe, Zhang Hong, Chaudhari Puja Bk, Zhong Wei, Yu Jiakang
Department of Neonatal Surgery, Guangzhou Women and Children's Medical Center, Guangzhou 510623, Guangdong Province, China.
Institute of Pediatrics, Guangzhou, Women and Children's Medical Center, Guangzhou 510623, Guangdong Province, China.
J Pediatr Surg. 2018 Oct;53(10):1914-1917. doi: 10.1016/j.jpedsurg.2018.03.027. Epub 2018 Apr 5.
The aim of this study was to report our experience using the Bishop-Koop procedure for the treatment of various surgical problems of jejunoileal atresia including luminal discrepancy, complex meconium peritonitis, type IIIb and type IV atresia which we defined as severe jejunoileal atresia.
This retrospective study was performed on the patients with severe jejunoileal atresia who underwent Bishop-Koop procedure at a tertiary center in China over a five year of period. The mortality, complication rate, nutrition status and the risk factors for postoperative adverse outcomes were explored.
A total of 41 neonates underwent the Bishop-Koop procedure. The median duration of the hospital stay and total parenteral nutrition and the point at which oral feeding was initiated postoperatively were 24 days (95% CI =18.99-29.01), 13 days (95% CI = 9.03-16.97) and 11 days (95% CI = 10.17-11.83) respectively. The mortality rate was 7.32% (3/41). The complication rate was 41.4% (17/41) including anastomotic leak, intestinal obstruction, high output stoma and cholestasis. The weight for age Z-score at stoma closure was restored to normal levels (-0.86, 95% confidence interval (CI) = -1.44, -0.28). The main factor associated with adverse outcomes in severe jejunoileal atresia was premature delivery (odds ratio (OR) = 4.44, 95% CI = 1.06-18.67).
Bishop-Koop procedure appears to be a technically efficient method for severe jejunoileal atresia, although larger studies are needed to compare Bishop-Koop procedure and other operation techniques.
Therapeutic.
Level IV.
本研究旨在报告我们使用毕晓普 - 库普手术治疗空回肠闭锁各种外科问题的经验，这些问题包括管腔差异、复杂性胎粪性腹膜炎、Ⅲb型和Ⅳ型闭锁（我们将其定义为严重空回肠闭锁）。
对在中国一家三级中心接受毕晓普 - 库普手术的严重空回肠闭锁患者进行了这项回顾性研究。探讨了死亡率、并发症发生率、营养状况以及术后不良结局的危险因素。
共有41例新生儿接受了毕晓普 - 库普手术。住院时间中位数、全胃肠外营养时间以及术后开始经口喂养的时间分别为24天（95%可信区间[CI]=18.99 - 29.01）、13天（95%CI = 9.03 - 16.97）和11天（95%CI = 10.17 - 11.83）。死亡率为7.32%（3/41）。并发症发生率为41.4%（17/41），包括吻合口漏、肠梗阻、高流量造口和胆汁淤积。造口关闭时的年龄别体重Z评分恢复到正常水平（-0.86，95%可信区间[CI]= -1.44，-0.28）。严重空回肠闭锁不良结局的主要相关因素是早产（比值比[OR]=4.44，95%CI = 1.06 - 18.67）。
毕晓普 - 库普手术似乎是治疗严重空回肠闭锁的一种技术上有效的方法，尽管需要更大规模的研究来比较毕晓普 - 库普手术和其他手术技术。
治疗性研究。
Ⅳ级。
