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| Operation approach to children with congenital duodenal diaphragm |
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LU Chang-gui, TANG Wei-bing, GEN Qi-ming, XU Xiao-qun, JIANG Wei-wei, CHEN Huan, LV Xiao-feng |
(Department of Neonatal Surgery, the Affiliated Nanjing Children′s Hospital of Nanjing Medical University, Nanjing Jiangsu 210008, China) |
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Abstract Objective: To determine whether diaphragmectomy or diamond-shaped anastomosis is the more effective treatment in infants with perforate duodenal diaphragm. Methods: Seventy-two infants with congenital duodenal diaphragm were divided into neonatal group(<30 d), younger infant group(30-60 d) and elder infant group(≥60 d). Each age group were divided into diaphragmectomy group and diamond-shaped anastomosis group according to the operation approach. Duration of operation, functional recovery time of alimentary canal, total enteral nutrition, postoperative hospital stay, body weight in 2 months and 6 months after surgery, postoperative incidence of obstructive jaundice, postoperative recurrence incidence of bilious vomiting were recorded and compared. Results: In neonatal group, patients who underwent diaphragmectomy showed shorter operational time, total enteral nutrition time and hospital stay, compared with diamond-shaped anastomosis patients. In younger infant group, patients who underwent diaphragmectomy had shorter operation time and lower weight in 2 months after surgery,but longer total enteral nutrition time and hospital stay, compared with diamond-shaped anastomosis patients. In elder infant group, compared with diamond-shap anastomosis group, patients in diaphragmectomy group showed longer functional recovery time, total enteral nutrition time and hospital stay, higher postoperative recurrence incidence of bilious vomiting (P＜0.05). Conclusion: To younger infants with perforate duodenal diaphragm, the diaphragmectomy was more suitable, while diamond-shaped anastomosis was better to elder ones.
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Received: 19 March 2013
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2013, Vol. 23 
