Transanastomotic tube in intestinal atresia: How beneficial are they?

Abstract

Introduction: Intestinal atresia requires multiple surgeries and long hospital stay. We tried managing these cases by primary anastomosis with transanastomotic tube (TAT) for early feeding. Aims: The aim of the study was to analyse the outcomes in patients of intestinal atresia who underwent primary anastomosis with a TAT. Materials and Methods: The records between June 2014 and November 2017 were analysed. Those with incomplete data or unclear final outcome were excluded. Patients managed by primary anastomosis with TAT (Group A) or without TAT (Group B) were included. The TAT was kept for 6 weeks. Oral feeds were started after 2 weeks in all the cases. P < 0.05 was considered as statistically significant. Results: Forty-eight cases were included. There were two duodenal atresia, 29 jejunal atresia and 17 ileal atresia. The mean age at surgery was 2 days (range: 1–16 days). There were 42 cases in Group A (with TAT) and six in Group B (without TAT). The average duration of start of feeds was 78 h (range: 72–96 h) in Group A and 402 h (range: 360–504 h) in Group B (P = 0.01). The mean duration of hospital stay was 7 days (range: 5–15 days) and 27 days (range: 19–48 days) in Group A and B, respectively (P = 0.02). The overall survival was 38 (91%) and 3 (50%) in Group A and B, respectively (P = 0.01). Reexploration was required in 2/42 and 2/6 cases in Group A and B, respectively (P = 0.4). Total parental nutrition was required in 2/42 and all cases in Group A and B, respectively. Conclusion: Primary repair in intestinal atresia with a TAT is a practical option. The overall outcome is better.

Keywords

• intestinal atresia
• tapering enteroplasty
• total parental nutrition
• transanastomotic tube
• witzel's principle