Association between postoperative feeding patterns and gastrointestinal function reconstruction after congenital intestinal atresia in neonates.

Abstract

Background: Congenital intestinal atresia (CIA) is a common intestinal malformation in the neonatal period, and surgery is currently the main treatment method. The choice of postoperative feeding is crucial for the recovery of gastrointestinal function in children.

Aim: To compare and analyze the effects of different postoperative feeding methods on gastrointestinal function reconstruction in newborns with CIA.

Methods: Twenty-six children diagnosed with neonatal CIA, treated with minimally invasive surgery at Shijiazhuang Maternal and Child Health Hospital between January 2021 and May 2024, were selected for this single-center prospective randomized controlled study. They were divided into two groups using envelope randomization: Enteral nutrition (EN) group (n = 13) and parenteral nutrition (PN) group (n = 13). Baseline and clinical characteristics were collected, and recovery time of bowel sounds and time to first defecation were used as evaluation indices for gastrointestinal functional reconstruction. Differences between the groups were analyzed using t-test, χ ² test, and Fisher's exact test. Spearman's correlation tests and linear regression models were employed to analyze factors influencing time to first defecation.

Results: The time to bowel sound recovery (51.54 vs 65.85, P = 0.013) and first defecation (58.15 vs 76.62, P < 0.001) was shorter in the EN group compared to the PN group. Clinical improvements in the EN group, including discharge weight (P = 0.044), hospital stay (P = 0.027), white blood cell count (P = 0.023), albumin content (P = 0.013), and direct bilirubin content (P = 0.018), were also better than those in the PN group. No substantial differences in postoperative complications were found between the groups. Correlation analysis indicated that abdominal infection and operation time may relate to time to first defecation. Linear regression analysis demonstrated a considerable association between EN feeding and shorter time to first defecation. Abdominal infection and an operation time > 2 hours may be risk factors for prolonged time to first defecation.

Conclusion: EN substantially promotes the recovery of gastrointestinal function after CIA in neonates and can improve clinical outcomes in children. Future research should explore optimal EN practices to enhance clinical application and child health.