Prospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Apr 27, 2025; 17(4): 102980
Published online Apr 27, 2025. doi: 10.4240/wjgs.v17.i4.102980
Association between postoperative feeding patterns and gastrointestinal function reconstruction after congenital intestinal atresia in neonates
Hui-Ling Kang, Yue-Zhi Zhao
Hui-Ling Kang, Department of Neonatology, Shijiazhuang Maternal and Child Health Hospital, Shijiazhuang 050006, Hebei Province, China
Yue-Zhi Zhao, Department of Surgical Anesthesia, Shijiazhuang Maternal and Child Health Hospital, Shijiazhuang 050006, Hebei Province, China
Author contributions: Zhao YZ designed the research; Kang HL performed the research, contributed to the new reagents or analytic tools, analyzed data, and wrote the paper.
Institutional review board statement: The study was reviewed and approved by the Shijiazhuang Maternal and Child Health Hospital Institutional Review Board, No. 202123.
Clinical trial registration statement: This study has not been registered.
Informed consent statement: All subjects agreed to the study protocol and voluntarily signed the informed consent form.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: The data can’t be available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yue-Zhi Zhao, Associate Chief Nurse, Department of Surgical Anesthesia, Shijiazhuang Maternal and Child Health Hospital, No. 396 Youyi South Street, Qiaoxi District, Shijiazhuang 050006, Hebei Province, China. zyz3860547996@163.com
Received: November 28, 2024
Revised: December 26, 2024
Accepted: March 3, 2025
Published online: April 27, 2025
Processing time: 120 Days and 23.5 Hours
Abstract
BACKGROUND

Congenital intestinal atresia (CIA) is a common intestinal malformation in the neonatal period, and surgery is currently the main treatment method. The choice of postoperative feeding is crucial for the recovery of gastrointestinal function in children.

AIM

To compare and analyze the effects of different postoperative feeding methods on gastrointestinal function reconstruction in newborns with CIA.

METHODS

Twenty-six children diagnosed with neonatal CIA, treated with minimally invasive surgery at Shijiazhuang Maternal and Child Health Hospital between January 2021 and May 2024, were selected for this single-center prospective randomized controlled study. They were divided into two groups using envelope randomization: Enteral nutrition (EN) group (n = 13) and parenteral nutrition (PN) group (n = 13). Baseline and clinical characteristics were collected, and recovery time of bowel sounds and time to first defecation were used as evaluation indices for gastrointestinal functional reconstruction. Differences between the groups were analyzed using t-test, χ2 test, and Fisher’s exact test. Spearman’s correlation tests and linear regression models were employed to analyze factors influencing time to first defecation.

RESULTS

The time to bowel sound recovery (51.54 vs 65.85, P = 0.013) and first defecation (58.15 vs 76.62, P < 0.001) was shorter in the EN group compared to the PN group. Clinical improvements in the EN group, including discharge weight (P = 0.044), hospital stay (P = 0.027), white blood cell count (P = 0.023), albumin content (P = 0.013), and direct bilirubin content (P = 0.018), were also better than those in the PN group. No substantial differences in postoperative complications were found between the groups. Correlation analysis indicated that abdominal infection and operation time may relate to time to first defecation. Linear regression analysis demonstrated a considerable association between EN feeding and shorter time to first defecation. Abdominal infection and an operation time > 2 hours may be risk factors for prolonged time to first defecation.

CONCLUSION

EN substantially promotes the recovery of gastrointestinal function after CIA in neonates and can improve clinical outcomes in children. Future research should explore optimal EN practices to enhance clinical application and child health.

Keywords: Congenital intestinal atresia; Enteral nutrition; Gastrointestinal function reconstruction; Neonatal postoperative feeding; Surgical prognosis

Core Tip: This study demonstrated that enteral nutrition (EN) significantly accelerates gastrointestinal function recovery in neonates with congenital intestinal atresia after surgery compared to parenteral nutrition. EN reduces bowel sound recovery time and time to first defecation, while improving nutritional status and clinical outcomes. These findings highlight the importance of prioritizing EN in postoperative feeding strategies for neonatal congenital intestinal atresia to enhance recovery and overall prognosis.