Management of colonic atresia with primary resection and anastomosis

Abstract

Historically, the majority of patients with colonic atresia have been managed by ostomy creation at the time of initial operation; conversely, we have tended to treat the atresia with resection and anastomosis. The purpose of this study is to determine the rate of concomitant Hirschsprung's disease and to identify potential morbidity associated with primary repair. After IRB approval (#105825), charts of patients identified by ICD-9 code as having colonic atresia, who were admitted to our institution between 1993 and 2008 were, retrospectively, reviewed. Particular attention was paid to demographic data, comorbidities, operative therapy, and complications. Continuous variables were compared using an unpaired t test. A P value of <0.05 was considered significant. Twelve newborns with colonic atresia were identified. Two babies were managed initially with ostomy, both of whom had gastroschisis; primary repair was performed on ten, with two undergoing simultaneous rectal biopsy. No anastomotic complications occurred and there were no mortalities. One patient experienced self-limited malabsorption symptoms after repair. No cases of Hirschsprung's disease were detected. Uncomplicated colonic atresia can be managed by primary repair with little morbidity.