40 years' review of intestinal atresia

Chin Med J (Engl). 1999 Jul;112(7):583-5.


Objective: To analyze the 40 years' experience of intestinal atresia and to introduce a new design of long-oblique anastomosis for disproportional loops of the intestine.

Methods: A total of 449 cases of congenital atresia of the small intestine were classified into three groups according to the embryopathology: high group (145 cases), including duodenal and high jejunal atresia; middle group (288), including ileo-jejunal atresia; and low group (16), including terminal ileal atresia. To analyze the survival rate and mode of treatment, we assigned the cases into 3 groups according to the year of admission: 1) 1956-1969 (173 cases), under the general pediatric surgical care; 2) 1970-1985 (147), under the specialty neonatal surgical care; and 3) 1986-1996 (129), with additional use of total parenteral nutrition.

Results: The ileojejunal atresia group (middle group) had the highest mortality rate (47.6%). The overall mortality rate decreased as the time went by, dropping from 64.7% in the early years down to 18.6% in the recent years, and no hospital death occurred in the recent couple of years.

Conclusion: Besides the improvement of neonatal surgical techniques, selecting a proper surgical procedure according to the embryopathology is essential to the reduction of mortality. The long-oblique anastomosis is particularly acceptable in China at present for marked disproportional loops.

Publication types

  • Review

MeSH terms

  • Anastomosis, Surgical / methods
  • Digestive System Surgical Procedures / methods
  • Humans
  • Intestinal Atresia / classification
  • Intestinal Atresia / mortality
  • Intestinal Atresia / surgery*