Clinical Profile, Outcomes and Predictors of Mortality in Neonates Operated for Gastrointestinal Anomalies in a Tertiary Neonatal Care Unit- An Observational Study

Jerry, Antony Leo; Amboiram, Prakash; Balakrishnan, Umamaheswari; Chandrasekaran, Ashok; Agarwal, Prakash; Devi, Usha

doi:10.4103/jiaps.jiaps_10_21

Cited by 5 publications

References 19 publications

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Post-discharge follow-up of congenital duodenal obstruction patients: a systematic review

Lum Min,

Imam,

Zrinyi

et al. 2023

Pediatr Surg Int

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Long-term follow-up of congenital duodenal obstruction patients often falls on care providers with little experience of this condition. We performed a systematic review of the long-term outcomes of duodenal obstruction and provide a summary of sequelae care providers should anticipate. METHODSIn 2022, after registering with PROSPERA, Medline (Ovid), EMBASE, PSYCHINFO, CNAHL and SCOPUS databases were searched using the title keyword 'intestinal atresia'. Abstracts were ltered for inclusion if they included the duodenum. Papers of ltered abstracts were included if they reported post-discharge outcomes. Methodological Index for Non-Randomized Studies was used to grade the papers. RESULTSOf the 1068 abstracts were screened, 32 papers were reviewed. Eleven studies were included. Thirty additional papers were included after reviewing references, for a total of 41 papers. The average MINORS was 7/16. CONCLUSIONSThere is good evidence that children with congenital duodenal obstruction do well in terms of survival, growth and general well-being. Associated cardiac, musculoskeletal and renal anomalies should be ruled-out. Care providers should be aware of anastomotic dysfunction, blind loop syndrome, bowel obstruction and re ux. Re ux may be asymptomatic. Laparoscopic repair does not change long-term outcomes, and associated Trisomy 21 worsens neurodevelopmental outcomes. Identi cation of studiesWe performed a literature search of the databases Medline (Ovid), EMBASE, PSYCHINFO, CINAHL and SCOPUS using the keywords 'intestinal atresia', 'apple peel', 'jejunal atresia' and 'intestinal atresia'. Including 'ileal', 'duodenal' and 'colonic' did not change the results. We initially included studies for any site of intestinal atresia then divided the papers by the site of intestinal atresia: duodenal, jejuno-ileal and colonic. This review includes our summary of the duodenal literature. Jejuno-ileal and colonic reviews will be addressed in separate manuscripts. The original search was performed in June 2020 and a second search was performed in June 2022. No limitations were placed on publication date or language. Abstracts were uploaded to Rayyan, an online systematic review website [4].Within Rayyan, abstracts were independently ltered for possible inclusion by two authors (MI, SLM). The same two authors then agreed on which complete studies to review based on the ltered abstracts. Complete papers were independently assessed for possible inclusion by two authors (MI, SLM). If a con ict arose regarding inclusion or exclusion, papers were assessed by a third reviewer (AS). References of included papers were manually searched to identify papers that met the inclusion criteria but were not identi ed through the electronic database searches.

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Post-discharge follow-up of congenital duodenal obstruction patients: a systematic review

Lum Min,

Imam,

Zrinyi

et al. 2023

Pediatr Surg Int

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Morbidity and Mortality of Newborns with Gastrointestinal Surgical Pathology Admitted to the Neonatology Service of the Vicente Corral Moscoso Hospital

Villacis-Astúa,

Ulloa-Pesántez

2023

espoch

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Morbidity and mortality in newborns with gastrointestinal malformations are high, even more so in low- and middle-income countries due to the need for immediate surgical care. However, the literature on these anomalies is scarce in Ecuador. This research aims to increase the registered data on the morbidity and mortality of newborns with gastrointestinal surgical pathology in Cuenca, Ecuador. A descriptive and cross-sectional study was carried out, involving 63 newborns with gastrointestinal surgical pathology admitted to the neonatology service of the Vicente Corral Moscoso Hospital. Data collection was done by reviewing medical records, using a form. The results showed that the mortality rate was higher in 2020. The majority of live newborns had esophageal atresia, they were male, born at term, with middle-aged mothers from urban areas. Of the deceased, the majority had a congenital diaphragmatic hernia, they were children of mothers from rural areas, and half died within 24 hours of being born, mainly from septic shock. In conclusion, the results of this study should not be considered definitive due to the omission of 23 clinical histories; moreover, a low mortality rate is evidenced. It was also observed that they died mainly from septic shock, a preventable cause of mortality from the first level of care with the detection of maternal risk factors. Keywords: morbidity, mortality, malformation, surgical neonate. Resumen Antecedentes: la morbimortalidad en recién nacidos con malformaciones gastrointestinales es elevada, más aún en países de ingresos medios y bajos debido a la necesidad de atención quirúrgica inmediata, sin embargo la literatura sobre estas anomalías es escasa en el Ecuador. Objetivos: incrementar los datos registrados sobre la morbimortalidad de recién nacidos con patología quirúrgica gastrointestinal en Cuenca, Ecuador. Métodos: se realizó un estudio descriptivo y transversal, participaron 63 recién nacidos con patología quirúrgica gastrointestinal ingresados en el servicio de neonatología del Hospital Vicente Corral Mosoco. La recolección de datos se realizó mediante la revisión de historias clínicas, empleando un formulario. Resultados: la tasa de mortalidad fue mayor, en el año 2020. La mayoría de recién nacidos vivos tenían atresia esofágica, eran hombres, nacidos a término, con madres de edad media, procedentes de zonas urbanas. De los fallecidos, la mayoría tenía hernia diafragmática congénita, eran hijos de madres procedentes de zonas rurales, la mitad murió a las 24 horas de nacido, principalmente de shock séptico. Conclusiones: los resultados de este estudio no deben considerarse como definitivos, debido a la omisión de 23 historias clínicas, se evidencia una baja tasa de mortalidad. También se observó que fallecieron principalmente de shock séptico, una causa de mortalidad prevenible desde el primer nivel de atención con la detección de factores de riesgo maternos. Palabras Clave: Morbilidad. Mortalidad. Malformación. Neonato quirúrgico.

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Post-discharge follow-up of congenital duodenal obstruction patients: A systematic review

Min

Imam

Zrinyi

et al. 2022

Preprint

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PURPOSE Long-term follow-up of congenital duodenal obstruction patients often falls on care providers with little experience of this condition. We performed a systematic review of the long-term outcomes of duodenal obstruction and provide a summary of sequelae care providers should anticipate. METHODS In 2022, after registering with PROSPERA, Medline (Ovid), EMBASE, PSYCHINFO, CNAHL and SCOPUS databases were searched using the title keyword ‘intestinal atresia’. Abstracts were filtered for inclusion if they included the duodenum. Papers of filtered abstracts were included if they reported post-discharge outcomes. Methodological Index for Non-Randomized Studies was used to grade the papers. RESULTS Of the 1068 abstracts were screened, 32 papers were reviewed. Eleven studies were included. Thirty additional papers were included after reviewing references, for a total of 41 papers. The average MINORS was 7/16. CONCLUSIONS There is good evidence that children with congenital duodenal obstruction do well in terms of survival, growth and general well-being. Associated cardiac, musculoskeletal and renal anomalies should be ruled-out. Care providers should be aware of anastomotic dysfunction, blind loop syndrome, bowel obstruction and reflux. Reflux may be asymptomatic. Laparoscopic repair does not change long-term outcomes, and associated Trisomy 21 worsens neurodevelopmental outcomes.

show abstract

Clinical Profile, Outcomes and Predictors of Mortality in Neonates Operated for Gastrointestinal Anomalies in a Tertiary Neonatal Care Unit- An Observational Study

Cited by 5 publications

References 19 publications

Post-discharge follow-up of congenital duodenal obstruction patients: a systematic review

Post-discharge follow-up of congenital duodenal obstruction patients: a systematic review

Morbidity and Mortality of Newborns with Gastrointestinal Surgical Pathology Admitted to the Neonatology Service of the Vicente Corral Moscoso Hospital

Post-discharge follow-up of congenital duodenal obstruction patients: A systematic review

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