Comparison of Two Diffrent Method of Surgery in Ileus Meconium

meconium ileus is obstruction of the terminal ileum by abnormally tenacious meconium; it most often occurs in neonates with cystic fibrosis. Meconium ileus accounts for up to 33% of neonatal small-bowel obstructions. Symptoms include emesis that may be bilious, abdominal distention, and failure to pass meconium in the first several days of life. Diagnosis is based on clinical presentation and x-rays. Treatment is enemas with dilute contrast under fluoroscopy and surgery if enemas fail. Various surgical procedures are described and practiced for operative management of uncomplicated meconium ileus. In our series, we have compared two differnt method of surgery.primary resection and anastomosis and bishop koop method of enterostomy .we compared their effectivness and complications.

Forty neonates with ileus meconium included in study, 20 patient in each group., allocating every other subject to each treatment group (alternating allocation) for the bishop koop enterostomy and anastomosis(study group) or primary resection and anastomosis(controll group). The results of treatment and complications during and after the surgery were recorded in both groups and compared together.
there was 3 case of mortality in study group(%15) and 8 case of mortality in controll group(%40).there was meaningful statistical differrences between mortality in two groups..p=0/30 and p=0/002.
in contrast of advantage of one stage repair and primary resection and anastomosis in meconium ileus neonates it has more mortality compare to bishop koop method., performing the two-stage bishop koop repair is more safe and recommended for this anomally