Management and outcomes of Jejunoileal atresia within the United Kingdom
Management and outcomes of Jejunoileal atresia within the United Kingdom
Background
Jejunoileal atresia (JIA) is seen in 0.7 per 10,000 births and requires early surgical intervention to restore gastrointestinal continuity. Many intra-operative techniques exist to manage the atresia depending on anatomy encountered and proximal bowel dilatation. Existing studies are predominantly single centre experiences. This study aims to report contemporary management and outcomes of JIA in the United Kingdom (UK) and explore how operative technique is associated with outcome.
Methods
Multicentre UK based observational study over 5 years with follow-up to 1 year post surgery. Outcomes were time to full enteral feeds, length of stay, unplanned reoperation, number of general anaesthetics, development of short bowel syndrome and mortality. These outcomes were stratified by infant related, disease related and surgical technique related factors.
Results
There were 159 infants with JIA from seven tertiary paediatric surgical units. JIA was suspected antenatally in 92 (57.8 %) infants and associated congenital anomalies were seen in 47 (29.6 %) infants. Age at surgery was 2 (0–70) days and primary anastomosis was undertaken in 114 (71.7 %) procedures most commonly (87.9 %) via end-to-end anastomosis. Primary anastomosis was associated with shorter duration to full enteral feeds (21 vs 60 days, p = 0.001), shorter length of stay (28 vs 78 days, p < 0.001), fewer general anaesthetics (1 vs 3, p < 0.001) and lower mortality (0.9 vs 11.1 %, p = 0.002) than enterostomy formation. Overall, unplanned reoperation was required in 27 (17.0 %) infants primarily for intestinal obstruction (n = 21/27).
Conclusions
These data provide contemporary outcomes by atresia type and highlight obstructive complications are frequent in this cohort. These data support primary anastomosis in JIA.
Enterostomy, Jejunoileal atresia, Neonatal surgery, Outcomes, Primary anastomosis
Bethell, George
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Hughes, Belinda
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Varik, Roma S
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Chong, Clara
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Hall, Nigel
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Munean, Ancuta
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Gozzini, Sara
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Fagelnor, Anas
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Mustafa, Ibrahim
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Amin, Amir
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Joshi, Ashwini
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Peeraully, Riyad
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Melling, Charlotte
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Cooper, Eden
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Jester, Ingo
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Saxena, Amulya
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July 2025
Bethell, George
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Hughes, Belinda
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Varik, Roma S
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Chong, Clara
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Hall, Nigel
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Munean, Ancuta
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Gozzini, Sara
2af0902f-3e6f-4a5c-83ea-61cbe9696216
Fagelnor, Anas
ba348109-c970-418c-9723-58f66027db7a
Mustafa, Ibrahim
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Amin, Amir
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Joshi, Ashwini
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Peeraully, Riyad
ace2b8c7-068b-4ec3-b6d3-b5523218c11c
Melling, Charlotte
fbe14b89-66ca-48cf-ab71-4e49ee862e89
Cooper, Eden
51b2b8c1-2a4b-4c28-8aec-cd352d4bcbd8
Jester, Ingo
8ca1f6b1-e169-4d28-b253-3cd9a4f00547
Saxena, Amulya
e7940970-f8c9-4439-9dfa-084a123ad6c3
Bethell, George, Hughes, Belinda, Varik, Roma S, Chong, Clara, Hall, Nigel, Munean, Ancuta, Gozzini, Sara, Fagelnor, Anas, Mustafa, Ibrahim, Amin, Amir, Joshi, Ashwini, Peeraully, Riyad, Melling, Charlotte, Cooper, Eden, Jester, Ingo and Saxena, Amulya
(2025)
Management and outcomes of Jejunoileal atresia within the United Kingdom.
Journal of Pediatric Surgery, 60 (7), [162334].
(doi:10.1016/j.jpedsurg.2025.162334).
Abstract
Background
Jejunoileal atresia (JIA) is seen in 0.7 per 10,000 births and requires early surgical intervention to restore gastrointestinal continuity. Many intra-operative techniques exist to manage the atresia depending on anatomy encountered and proximal bowel dilatation. Existing studies are predominantly single centre experiences. This study aims to report contemporary management and outcomes of JIA in the United Kingdom (UK) and explore how operative technique is associated with outcome.
Methods
Multicentre UK based observational study over 5 years with follow-up to 1 year post surgery. Outcomes were time to full enteral feeds, length of stay, unplanned reoperation, number of general anaesthetics, development of short bowel syndrome and mortality. These outcomes were stratified by infant related, disease related and surgical technique related factors.
Results
There were 159 infants with JIA from seven tertiary paediatric surgical units. JIA was suspected antenatally in 92 (57.8 %) infants and associated congenital anomalies were seen in 47 (29.6 %) infants. Age at surgery was 2 (0–70) days and primary anastomosis was undertaken in 114 (71.7 %) procedures most commonly (87.9 %) via end-to-end anastomosis. Primary anastomosis was associated with shorter duration to full enteral feeds (21 vs 60 days, p = 0.001), shorter length of stay (28 vs 78 days, p < 0.001), fewer general anaesthetics (1 vs 3, p < 0.001) and lower mortality (0.9 vs 11.1 %, p = 0.002) than enterostomy formation. Overall, unplanned reoperation was required in 27 (17.0 %) infants primarily for intestinal obstruction (n = 21/27).
Conclusions
These data provide contemporary outcomes by atresia type and highlight obstructive complications are frequent in this cohort. These data support primary anastomosis in JIA.
Text
JIA Final accepted version
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Restricted to Repository staff only until 12 April 2026.
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More information
Accepted/In Press date: 12 April 2025
e-pub ahead of print date: 21 April 2025
Published date: July 2025
Additional Information:
Authors: George S Bethell, Belinda Hughes, Roma S Varik, Clara Chong, Nigel Hall, Ancuta Muntean, Sara Gozzini, Anas Fagelnor, Ibrahim Mustafa, Amir Amin, Ashwini Joshi, Riyad Peeraully, Charlotte Melling, Eden Cooper, Ingo Jester and Amulya Saxena
Keywords:
Enterostomy, Jejunoileal atresia, Neonatal surgery, Outcomes, Primary anastomosis
Identifiers
Local EPrints ID: 501268
URI: http://eprints.soton.ac.uk/id/eprint/501268
ISSN: 0022-3468
PURE UUID: e24d0b49-2e39-4523-a216-b2fab447366d
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Date deposited: 28 May 2025 16:36
Last modified: 11 Sep 2025 02:33
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Contributors
Author:
George Bethell
Author:
Belinda Hughes
Author:
Roma S Varik
Author:
Clara Chong
Author:
Ancuta Munean
Author:
Sara Gozzini
Author:
Anas Fagelnor
Author:
Ibrahim Mustafa
Author:
Amir Amin
Author:
Ashwini Joshi
Author:
Riyad Peeraully
Author:
Charlotte Melling
Author:
Eden Cooper
Author:
Ingo Jester
Author:
Amulya Saxena
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