Upadhyay V, Sakalkale R, Parashar K, Mitra S K, Buick R G, Gornall P, Corkery J J
Department of Surgery, Children's Hospital, Birmingham, UK.
Eur J Pediatr Surg. 1996 Apr;6(2):75-7. doi: 10.1055/s-2008-1066475.
To determine the most successful mode of treatment, 33 consecutive cases of duodenal atresia treated by duodenoduodenostomy and not associated with other gastro-intestinal anomalies were analysed retrospectively. These patients have been placed in a nonrandomised fashion into one of three groups: Group A: Duodenostomy (side to side) with gastrostomy and transanastomotic feeding tube (n = 12); Group B: Duodenoduodenostomy (diamond shape) with jejunostomy feeding tube (n = 12); Group C: Duodenoduodenostomy (diamond shape) only (n = 9). A nasogastric tube was used in all cases. There was no difference between the groups for gestational age, birthweight, and age at operation. The outcome measures used to compare these groups were the time taken to achieve full preanastomotic feeds and the duration of hospital stay. There was no difference in time taken to achieve full pre-anastomotic feeds between Group A and Group B. Patients in Group C took significantly less time to achieve full pre-anastomotic feeds than either of the other two groups (p < 0.05, Mann-Whitney U). The duration of hospital stay was also significantly shorter for patients in Group C (median = 12 days) than for patients in either Group A or B (median = 24, 20 days respectively) (p < 0.05, Mann-Whitney U).
为确定最成功的治疗方式，我们回顾性分析了33例经十二指肠十二指肠吻合术治疗且未合并其他胃肠道畸形的十二指肠闭锁连续病例。这些患者被非随机地分为三组之一：A组：十二指肠造口术（侧侧吻合）加胃造口术和经吻合口喂养管（n = 12）；B组：菱形十二指肠十二指肠吻合术加空肠造口喂养管（n = 12）；C组：仅菱形十二指肠十二指肠吻合术（n = 9）。所有病例均使用鼻胃管。三组在胎龄、出生体重和手术年龄方面无差异。用于比较这些组的结局指标是达到完全吻合前喂养所需的时间和住院时间。A组和B组在达到完全吻合前喂养所需的时间上无差异。C组患者达到完全吻合前喂养所需的时间明显短于其他两组（p < 0.05，曼-惠特尼U检验）。C组患者的住院时间也明显短于A组或B组患者（中位数分别为12天、24天和20天）（p < 0.05，曼-惠特尼U检验）。
