Role of Transanastomotic Tube for Postoperative Management of Congenital Duodenal Atresia and Stenosis

Abstract

Purpose: Only a few reports have shown the benefits of the use of the transanastomotic tube (TAT) for the postoperative management of congenital duodenal atresia and stenosis. The purpose of this study is to verify the efficacy of TAT in the management of congenital duodenal occlusion, which started at our institute in 2012.

Methods: All neonates with congenital duodenal atresia and stenosis born from 2007 to 2014 were included in this study. The patients were classified into two groups: Non-TAT group (NT group: 2007–2011) and TAT group (T group: 2012–2014). Birth weight, gestational age, postoperative days until full feeding, central venous catheter placement periods, body weight loss ratio, and hospitalization periods were retrospectively studied and compared between the two groups.

Results: Seven patients were in the NT group and six patients were in the T group. The T group showed a significantly shorter time to reach full feeding after operation: NT group 13 days vs T group 6.5 days (p = 0.018). The T group also showed shortened postoperative days of central venous catheter placement: NT group 14 days vs T group 11.5 days (p = 0.049). The periods of hospitalization and phototherapy tended to be short without a significant difference.

Conclusions: TAT provides a significantly shorter duration for postoperative neonates to become fully fed and also provides early stable enteral feeding after operation of duodenal occlusion. TAT utilizing a central venous catheter also shortens the length of postoperative durations.