Munawir Makkadafi1,2, Aditya Rifqi Fauzi1, Setya Wandita3, Akhmad Makhmudi1. 1. Pediatric Surgery Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Jl. Kesehatan No. 1, Yogyakarta, 55281, Indonesia. 2. Department of Surgery, Faculty of Medicine, Hasanuddin University/RSUP Dr. Tadjuddin Chalid, Makassar, South Sulawesi, 90245, Indonesia. 3. Neonatology Division, Department of Child Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito Hospital, Yogyakarta, 55281, Indonesia.
Abstract
BACKGROUND: Several modifications of the Kimura procedure for congenital duodenal obstruction (CDO) have been reported, however, their effects on the outcomes show conflicting results. METHODS: We compared the CDO outcomes following the Kimura procedure with and without post-anastomosis jejunostomy feeding tube (JFT). RESULTS: A total of 52 CDO neonates were involved (JFT: 13 males and 2 females vs. non-JFT: 14 males and 23 females, p = 0.0019). Time to full oral feeding was significantly earlier in the JFT than non-JFT group (14 [interquartile range (IQR), 12-15] vs. 17 [IQR, 14-22.5] days; p = 0.04). Duration of parenteral nutrition given to infants with CDO after surgery was significantly shorter in the JFT than non-JFT group (12 [IQR, 10-15] vs. 17 [IQR, 13-23] days; p = 0.031). Moreover, enteral feeding was significantly earlier in the JFT than non-JFT group (2 [IQR, 1-3.5] vs. 5 [IQR, 4-6] days; p = < 0.0001). However, the length of stay following surgery was not significantly different between groups (16 [IQR, 14-22] vs. 20 [IQR, 17-28] days; p = 0.22). Also, overall patient survival did not significantly differ between JFT (66.7%) and non-JFT patients (59.5%) (p = 0.61). CONCLUSION: Jejunostomy feeding tube shows a beneficial effect on the time to full oral feeding, duration of parenteral nutrition and early enteral feeding in neonates with congenital duodenal obstruction after Kimura procedure.
BACKGROUND: Several modifications of the Kimura procedure for congenital duodenal obstruction (CDO) have been reported, however, their effects on the outcomes show conflicting results. METHODS: We compared the CDO outcomes following the Kimura procedure with and without post-anastomosis jejunostomy feeding tube (JFT). RESULTS: A total of 52 CDO neonates were involved (JFT: 13 males and 2 females vs. non-JFT: 14 males and 23 females, p = 0.0019). Time to full oral feeding was significantly earlier in the JFT than non-JFT group (14 [interquartile range (IQR), 12-15] vs. 17 [IQR, 14-22.5] days; p = 0.04). Duration of parenteral nutrition given to infants with CDO after surgery was significantly shorter in the JFT than non-JFT group (12 [IQR, 10-15] vs. 17 [IQR, 13-23] days; p = 0.031). Moreover, enteral feeding was significantly earlier in the JFT than non-JFT group (2 [IQR, 1-3.5] vs. 5 [IQR, 4-6] days; p = < 0.0001). However, the length of stay following surgery was not significantly different between groups (16 [IQR, 14-22] vs. 20 [IQR, 17-28] days; p = 0.22). Also, overall patient survival did not significantly differ between JFT (66.7%) and non-JFT patients (59.5%) (p = 0.61). CONCLUSION: Jejunostomy feeding tube shows a beneficial effect on the time to full oral feeding, duration of parenteral nutrition and early enteral feeding in neonates with congenital duodenal obstruction after Kimura procedure.
Entities:
Keywords:
Congenital duodenal obstruction; Enteral feeding; Full oral feeding; Jejunostomy feeding tube; Length of stay; Overall survival
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