DUODENAL ATRESIA - A COMPARISON OF 3 MODES OF TREATMENT

To determine the most successful mode of treatment, 33 consecutive cas es of duodenal atresia treated by duodenoduodenostomy and not associat ed with other gastro-intestinal anomalies were analysed retrospectivel y. These patients have been placed in a nonrandomised fashion into one of three groups. Group A: Duodenostomy (side to side) with gastrostom y and transanastomotic feeding tube (n = 12); Group B: Duodenoduodenos tomy (diamond shape) with jejunostomy feeding tube (n = 12); Group C: Duodenoduodenostomy (diamond shape) only (n = 9). A nasogastric tube w as used in all cases. There was no difference between the groups for g estational age, birthweight, and age at operation. The outcome measure s used to compare these groups were the time taken to achieve full pre anastomotic feeds and the duration of hospital stay. There was no diff erence in time taken to achieve full pre-anastomotic feeds between Gro up A and Group B. Patients in Group C took significantly less time to achieve full pre-anastomotic feeds than either of the other two groups (p < 0.05, Mann-Whitney U). The duration of hospital slay was also si gnificantly shorter for patients in Group C (median = 12 days) than fo r patients in either Group A or B (median = 24, 20 days respectively) (p < 0.05, Mann-Whitney U).