Primary anastomosis in jejunoileal atresia: A qualitative synthesis of outcomes, surgical techniques, and decision-making factors
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Jejunoileal atresia (JIA) is a frequent cause of neonatal intestinal obstruction requiring prompt surgical correction. While enterostomy has traditionally been used in complex or unstable cases, primary anastomosis (PA) is now widely regarded as the preferred surgical approach for JIA, owing to advances in neonatal care and surgical technique. This review aimed to synthesize current evidence on the safety, efficacy, and clinical outcomes of PA in neonates with JIA. This study conducted through a systematic search of PubMed, EMBASE, Web of Science, and Scopus included studies from 2010 to 2025. Nine observational cohort studies involving over 600 neonates were included. Outcomes assessed included surgical complications, mortality, reoperation, nutritional recovery, and hospital stay. Study quality was evaluated using the Newcastle–Ottawa Scale. Primary anastomosis was performed in up to 78 % of neonates and was associated with shorter time to full enteral feeding (median 17–22 days vs. up to 60 days in enterostomy), fewer general anesthetics, and reduced stoma-related complications. Despite a reoperation rate of 22–38 %, mostly due to dysmotility or obstruction, PA was associated with lower rates of mortality and major complication. Modified techniques like tapering enteroplasty improved feasibility in anatomically challenging cases. In contrast, Bishop–Koop procedures showed lower reoperation rates but were mostly reserved for high-risk patients. Primary anastomosis appears to be a safe and effective option for many neonates with JIA based on the available evidence, provided you are supported with postoperative effective neonatal care. Careful patient selection and surgical adaptation remain key to optimizing outcomes. Further high-quality studies are needed to strengthen these findings.
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Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it