Primary anastomosis in jejunoileal atresia: A qualitative synthesis of outcomes, surgical techniques, and decision-making factors
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.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.021 | 0.054 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.003 | 0.004 |
| Bibliometrics | 0.016 | 0.017 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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 itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".