Touloukian R J
Department of Surgery, Yale University School of Medicine, New Haven, Connecticut 06510.
World J Surg. 1993 May-Jun;17(3):310-7. doi: 10.1007/BF01658697.
A total of 116 cases of intestinal atresia or stenosis were encountered at the Yale-New Haven Hospital between 1970 and 1990. Sites involved were the duodenum (n = 61; 53%), jejunum or ileum (n = 47; 46%), and colon (n = 8; 7%). All but two patients underwent operative correction, for an overall survival rate of 92%. Challenging problems were the management of apple-peel atresia (five patients), multiple intestinal atresia with short-gut syndrome (eight patients), and proximal jejunal atresia with megaduodenum requiring imbrication duodenoplasty (four patients). Major assets in the improved outlook for intestinal atresia are prenatal diagnosis, regionalization of neonatal care, improved recognition of associated conditions, innovative surgical methods, and uncomplicated long-term total parenteral nutrition.
1970年至1990年间,耶鲁-纽黑文医院共收治了116例肠闭锁或肠狭窄患者。受累部位包括十二指肠(61例,占53%)、空肠或回肠(47例,占46%)以及结肠(8例,占7%)。除两名患者外,所有患者均接受了手术矫正,总体生存率为92%。具有挑战性的问题包括苹果皮样闭锁的处理(5例患者)、伴有短肠综合征的多发性肠闭锁(8例患者)以及需要行十二指肠折叠成形术的近端空肠闭锁合并巨十二指肠(4例患者)。肠闭锁预后改善的主要因素包括产前诊断、新生儿护理区域化、对相关病症的认识提高、创新的手术方法以及无并发症的长期全胃肠外营养。