Is Tapering Enteroplasty an Alternative to Resection of Dilated Bowel in Small Intestinal Atresia?

J Surg Res. 2020 Feb:246:1-5. doi: 10.1016/j.jss.2019.08.014. Epub 2019 Sep 18.


Background: Intestinal atresia is a congenital defect resulting in intestinal discontinuity and can be associated with significant morbidity related to intestinal failure. The bowel proximal to the atresia is often significantly dilated and dysfunctional. The treatment approaches of this dilated bowel include resection with primary anastomosis versus tapering enteroplasty with preservation of bowel length. The purpose of this study was to compare these two approaches in regard to bowel function as characterized by the time to full enteral feeding.

Methods: A retrospective review was performed of intestinal atresia repair performed at a tertiary referral pediatric hospital from 2007 to 2017. Length of stay, time to full enteral feeds, and complications were assessed in patients who underwent repair with tapering enteroplasty (n = 8) and compared with those who underwent resection and anastomosis (n = 39).

Results: The median age at surgery, gender distribution, weeks gestational age (WGA), location of the atresia, and comorbidities were similar between the two groups. Overall, there was no statistically significant difference in length of stay and time to full enteral feeds between groups. Three of eight (38%) patients in the tapered group and five of 39 patients (13%; P = 0.12) in the nontapered group underwent further surgical exploration because of bowel dysmotility. Factors associated with longer length of hospital stay were abdominal reoperation and WGA, and factors associated with longer time to full enteral feeds were WGA, abdominal reoperation, and gastroschisis.

Conclusions: Tapering enteroplasty at initial operation for intestinal atresias preserves bowel length and has statistically equivalent outcomes to resection and anastomosis in regard to the length of stay and time to full enteral feeds.

Keywords: Intestinal atresia; Tapering enteroplasty.

Publication types

  • Comparative Study

MeSH terms

  • Anastomosis, Surgical / adverse effects
  • Anastomosis, Surgical / methods
  • Digestive System Surgical Procedures / adverse effects*
  • Digestive System Surgical Procedures / methods
  • Dilatation, Pathologic / etiology
  • Dilatation, Pathologic / surgery
  • Enteral Nutrition / statistics & numerical data*
  • Female
  • Gastrointestinal Motility
  • Humans
  • Infant
  • Infant, Newborn
  • Intestinal Atresia / complications
  • Intestinal Atresia / surgery*
  • Intestine, Small / abnormalities*
  • Intestine, Small / surgery
  • Length of Stay / statistics & numerical data
  • Male
  • Plastic Surgery Procedures / adverse effects*
  • Plastic Surgery Procedures / methods
  • Postoperative Complications / epidemiology*
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery
  • Reoperation / methods
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Time Factors
  • Treatment Outcome

Supplementary concepts

  • Atresia of small intestine