Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Feb 8, 2017; 6(1): 40-44
Published online Feb 8, 2017. doi: 10.5409/wjcp.v6.i1.40
Cystic meconium peritonitis with jejunoileal atresia: Is it associated with unfavorable outcome?
Kin Wai Edwin Chan, Kim Hung Lee, Hei Yi Vicky Wong, Siu Yan Bess Tsui, Yuen Shan Wong, Kit Yi Kristine Pang, Jennifer Wai Cheung Mou, Yuk Him Tam
Kin Wai Edwin Chan, Kim Hung Lee, Hei Yi Vicky Wong, Siu Yan Bess Tsui, Yuen Shan Wong, Kit Yi Kristine Pang, Jennifer Wai Cheung Mou, Yuk Him Tam, Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, the Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China
Author contributions: Chan KWE contributed to the study design, literature search, manuscript writing and final revision of the article; Wong HYV, Tsui SYB, Wong YS, Pang KYK and Mou JWC performed the research; Lee KH and Tam YH contributed to supervision.
Institutional review board statement: The study was reviewed and approved by the Joint CUHK-NTEC Clinical Research Ethics Committee (CREC) (CRE Ref. No. 2016.225).
Informed consent statement: As anonymized administrative and clinical data were used for this study, specific written consent was not required to use patient information stored in hospital databases.
Conflict-of-interest statement: The authors declare that there is no conflict of interest to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Kin Wai Edwin Chan, MBChB, FRCSEd (Paed), FCSHK, FHKAM (Surgery), Division of Paediatric Surgery and Paediatric Urology, Department of Surgery, the Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong, China. edwinchan@surgery.cuhk.edu.hk
Telephone: +852-26322953 Fax: +852-26324669
Received: May 20, 2016
Peer-review started: May 24, 2016
First decision: July 27, 2016
Revised: September 21, 2016
Accepted: November 21, 2016
Article in press: November 22, 2016
Published online: February 8, 2017
Processing time: 258 Days and 19.9 Hours
Abstract
AIM

To compare the outcome between patients with jejunoileal atresia (JIA) associated with cystic meconium peritonitis (CMP) and patients with isolated JIA (JIA without CMP).

METHODS

A retrospective study was conducted for all neonates with JIA operated in our institute from January 2005 to January 2016. Demographics including the gestation age, sex, birth weight, age at operation, the presence of associated syndrome was recorded. Clinical outcome including the type of operation performed, operative time, the need for reoperation and mortality were studied. The demographics and the outcome between the 2 groups were compared.

RESULTS

During the study period, 53 neonates had JIA underwent operation in our institute. Seventeen neonates (32%) were associated with CMP. There was no statistical difference on the demographics in the two groups. Patients with CMP had earlier operation than patients with isolated JIA (mean 1.4 d vs 3 d, P = 0.038). Primary anastomosis was performed in 16 patients (94%) with CMP and 30 patients (83%) with isolated JIA (P = 0.269). Patients with CMP had longer operation (mean 190 min vs 154 min, P = 0.004). There were no statistical difference the need for reoperation (3 vs 6, P = 0.606) and mortality (2 vs 1, P = 0.269) between the two groups.

CONCLUSION

Primary intestinal anastomosis can be performed in 94% of patients with JIA associated with CMP. Although patients with CMP had longer operative time, the mortality and reoperation rates were low and were comparable to patients with isolated JIA.

Keywords: Meconium; Peritonitis; Atresia; Jejunoileal

Core tip: Owing to the adhesive and vascular nature of the meconium cyst, difficult operation is expected in patients with jejunoileal atresia associated with cystic meconium peritonitis. However, whether the overall mortality and morbidity is higher when compare to patients with isolated jejunoileal atresia is not known. Our results showed primary intestinal anastomosis could be performed in majority of neonates with cystic meconium peritonitis without an increase in morbidity and mortality.