Efforts to improve outcomes among neonates with complex intestinal atresia: a single-center low-income country experience

• DOI: 10.1007/s00383-024-05639-7
• Publication Date: 2024-03-06T14:02:52Z
• Authors: Innocent Okello; Caroline Q. Stephens; Nasser Kakembo; Phyllis Kisa; Stella Nimanya; Ava Yap; Anne S. Wesonga; Rovine Naluyimbazi; Peter Kayima; Yasin Ssewanyana; Doruk Ozgediz; John Sekabira
• Keywords: Intestinal atresia; Pediatric gastroenterology

Abstract Purpose Intestinal obstruction caused by intestinal atresia is a surgical emergency in newborns. Outcomes for the jejunal ileal (JIA), most common subtype of low-income countries (LIC), are poor. We sought to assess impact utilizing Bishop–Koop (BK) approach JIA improving outcomes. Methods A retrospective cohort study was performed on children with complex (Type 2–4) treated at our national referral hospital from 1/2018 12/2022. BK regularly used starting 1/1/2021, and outcomes between 1/2021 12/2022 were compared those 12/2020. Statistical significance set p < 0.05. Results total 122 neonates presented 1/2018–12/2022, 83 whom JIA. significant decrease ( = 0.03) noted patient mortality 2021 2022 n 33, 45.5% mortality) 2018–2020 35, 71.4% mortality). This translated risk reduction 0.64 (95% CI 0.41–0.98) increased use BK. Conclusion Increased anastomoses early enteral nutrition decreased primary anastomosis improves severe LIC settings. Implementing this LICs may help address disparities