Factors Affecting Survival in Patients with Small Bowel Atresia and Stenosis

Yıl 2022, Cilt: 17 Sayı: 2, 59 - 66, 15.07.2022

Selcan Türker Çolak , Murat Alkan , Recep Tuncer

https://doi.org/10.17517/ksutfd.938290

Öz

Objective: In this study we aimed to investigate the causes of morbidity and mortality and the factors that influence survival in life and growth in patients followed up with small bowel atresia/stenosis.
Material and Methods: Eighty five patients included to this study that admitted to our clinic with duodenal, proximal jejunoileal, distal jejunoileal atresia/stenosis between 2002-2012. Data on patient’s gender, prenatal diagnosis, time of diagnosis, time of birth, birth weight, maternal age, clinical features, associated anomalies, peroperative findings, postoperative hospitalisation, recorded and factors affecting morbidity, mortality and growth parameters analysed.
Results: Eighty five patients were included in this study, 44 female and 41 were male. Thirty five of these patients were duodenal, 29 proximal jejunoileal, 21 distal jejunoileal atresia/stenosis. 58% of the patients was premature. Additional congenital anomaly have seen at 74% of patients with duodenal atresia/
stenosis and 42% of jejunoileal atresia/stenosis. Mortality rate was 18%. Overall complication rate was 20% in all groups and the most common complication was sepsis. It was observed that the presence of congenital anomalies (100%), low birth weight (93%) and the prevalence of prematurity (80%) were increased in patients with mortality. Patients were examined in terms of growth and developement, in duodenal atresia/stenosis group body weight and persantiles were normal, in jejunoileal atresia group persantiles of length was lower.
Conclusion: In patients with small bowel atresia/stenosis prematurity, low birth weight and additional congenital anomalies were higher in patients who died. Appearance of very low rates of late-term complication should be related to the patient’s irregular long term follow up. In patients with jejunoileal atresia/stenosis, persantiles of length were lower and were commend close follow-up of patients for diet and growth in postoperative period.

Anahtar Kelimeler

Duodenal atresia, Jejunal atresia, Mortality, Stenosis

Proje Numarası

08.11.2012 13/7

İnce Barsak Atrezi ve Stenozu Olgularında Sağ Kalımı Etkileyen Faktörler

Öz

Amaç: İnce barsak atrezi/stenozu nedeniyle takip edilen hastaların morbidite ve mortalite nedenlerini ve sağ kalımı etkileyen faktörleri araştırmak, büyüme ve gelişmelerini incelemektir.
Gereç ve Yöntemler: 2002-2012 yılları arasında duodenal, proksimal jejunoileal, distal jejunoileal atrezi/stenoz nedeniyle takip edilen 85 hasta çalışmaya dâhil edildi. Hastaların cinsiyeti, prenatal tanısı olup olmadığı, tanı konulma zamanı, doğum haftası, kilosu, anne yaşı, klinik özellikleri, eşlik eden anomaliler, ameliyattaki bulgular, ameliyat sonrası hastanede kalış süresi ile ilgili veriler kaydedilerek morbidite ve mortaliteyi etkileyen faktörler ve büyüme gelişme parametreleri incelendi.
Bulgular: Çalışmaya dâhil edilen 85 hastanın 44’ü kız, 41’i erkekti. Hastaların 35’inde duodenal, 29’unda proksimal jejunoileal, 21’inde ise distal jejunoileal atrezi/stenoz mevcuttu. Hastaların %58’inde prematürite mevcuttu. Duodenal atrezi/stenozu olan hastalarda eşlik eden konjenital anomali oranı %74,
jejunoileal atrezi/stenozu olan hastalarda %42 idi. Çalışma grubunda mortalite oranı %18, erken ve geç dönem komplikasyon oranı %20 olup, en sık görülen komplikasyon sepsisti. Mortalite ile sonuçlanan hastalarda eşlik eden konjenital anomali varlığı (%100), düşük doğum ağırlığı (%93) ve prematürite sıklığının (%80) artmış olduğu görüldü. Hastalar büyüme gelişme açısından incelendiğinde duodenal atrezi/stenoz grubunda vücut ağırlığı ve kilo persentillerinin normal değerlerde olduğu, jejunoileal atrezilerde ise boy persentillerinin düşük olduğu tespit edildi.
Sonuç: İnce barsak atrezisi/stenozu nedeniyle tedavisi yapılan ve kaybedilen hastalarda prematürite, düşük doğum ağırlığı ve eşlik eden konjenital anomali sıklığının artmış olduğu bulunmuştur. Geç dönem komplikasyon oranının düşük olmasının, hastalardaki takip düzensizliğine bağlı veri eksikliğinden kaynaklandığı düşünülmüştür. Jejunoileal atrezi/stenozu olan hastalarda boy persentilleri düşük olup çalışma grubundaki tüm hastaların ameliyat sonrası dönemde beslenme ve büyüme-gelişme açısından yakın takip edilmesini öneriyoruz.

Anahtar Kelimeler

Duodenal atrezi, Jejunal atrezi, Mortalite, Stenoz

Proje Numarası

08.11.2012 13/7

Kaynakça

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