Multiple intestinal anastomosis in newborns and infants
- Authors: Kozlov Y.A.1,2,3, Mochalov M.N.1,2,3, Kovalkov K.A.4, Poloyan S.S.5, Baradieva P.Z.1, Zvonkov D.A.3, Ochirov C.B.1, Cheremnov V.S.1, Stankeev V.A.3, Rozhanski A.P.3, Kozlov S.Y.3, Sandakov Y.P.2
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Affiliations:
- Municipal Ivano-Matreninsky Children’s Clinical Hospital
- Irkutsk State Medical Academy of Continuous Education
- Irkutsk State Medical University
- Kemerovo Clinical Pediatric Hospital
- Center for Maternity and Childhood Protection
- Issue: Vol 25, No 3 (2021)
- Pages: 153-157
- Section: ORIGINAL ARTICLES
- Submitted: 19.07.2021
- Accepted: 19.07.2021
- Published: 19.07.2021
- URL: https://jps-nmp.ru/jour/article/view/294
- DOI: https://doi.org/10.18821/1560-9510-2021-25-3-153-157
- ID: 294
Cite item
Abstract
Introduction. The present trial systematizes data, taken from one surgical center as an example, on treating patients with intestinal atresia and necrotizing enterocolitis with multiple intestinal anastomoses.
Material and methods. The trial is a retrospective review on the treatment of 13 newborn infants who since 2010 have been put multiple intestinal anastomoses; the treatment was approved by the Hospital Ethics Committee. The average gestational age of patients was 31.2 weeks. The average age at the time of surgery – 7,9 days. Average weight - 2007 grams. The average number of anastomoses was 3.7 (range: 2-7). The average length of remained small intestine after the second surgery was 67.4 cm (range: 12-120 cm). No other surgical procedures, including gastrostomy or enterostomy, were performed. In all cases, surgical intervention ended with hermetic suturing of the abdominal cavity. Among them, there were 6 patients with the multifocal form of necrotizing enterocolitis; 6 patients had type IV atresia of the small intestine; 1 patient had the Ladd’s syndrome. Connection of intestinal segments was made by constructing several “end-to-end” anastomoses, double-row precision seam with PDS II 7/0 suture.
Results. In the postoperative period, complications associated with anastomosis construction, such as leakage and narrowing, were not recorded. Transit function of the gastrointestinal tract restored on day 4, on average, after the surgery (range: 2-6 days). There were no early lethal outcomes within the first 28 days after the surgery which were associated with the surgery. 2 patients with short bowel syndrome (remained small intestine was 12 and 25 cm) and multivisceral disorders died on day 72 and 64 after the surgery. Survived patients were transferred to full enteral feeding in 56 days, in average, after the second surgery (range - 15-120 days).
Conclusion. In our study, we have demonstrated potentials of a new surgical approach: one-stage formation of multiple intestinal anastomoses in case of multiple intestinal atresias as well as in case of multifocal forms of necrotizing enterocolitis. Maintaining the bowel length with multiple bowel anastomoses is very important factor for better survival of patients with the short bowel syndrome.
About the authors
Yu. A. Kozlov
Municipal Ivano-Matreninsky Children’s Clinical Hospital; Irkutsk State Medical Academy of Continuous Education; Irkutsk State Medical University
Author for correspondence.
Email: yuriherz@hotmail.com
ORCID iD: 0000-0003-2313-897X
Yury А. Kozlov, MD, PhD, DSc, prof., head of newborn department in Municipal Ivano-Matreninsky Children’s Clinical Hospital, Irkutsk; professor at Irkutsk State Medical Academy of Continuous Education, Irkutsk, 664049
РоссияM. N. Mochalov
Municipal Ivano-Matreninsky Children’s Clinical Hospital; Irkutsk State Medical Academy of Continuous Education; Irkutsk State Medical University
Email: fake@neicon.ru
Irkutsk, 664009; Irkutsk, 664049; Irkutsk, 664003
РоссияK. A. Kovalkov
Kemerovo Clinical Pediatric Hospital
Email: fake@neicon.ru
ORCID iD: 0000-0001-6126-4198
Kemerovo, 650056
РоссияS. S. Poloyan
Center for Maternity and Childhood Protection
Email: fake@neicon.ru
ORCID iD: 0000-0001-7042-6646
Krasnoyarsk, 660074
РоссияP. Zh. Baradieva
Municipal Ivano-Matreninsky Children’s Clinical Hospital
Email: fake@neicon.ru
ORCID iD: 0000-0002-5463-6763
Irkutsk, 664009
РоссияD. A. Zvonkov
Irkutsk State Medical University
Email: fake@neicon.ru
ORCID iD: 0000-0002-7167-2520
Irkutsk, 664003
РоссияCh. B. Ochirov
Municipal Ivano-Matreninsky Children’s Clinical Hospital
Email: fake@neicon.ru
ORCID iD: 0000-0002-6045-1087
Irkutsk, 664009
РоссияV. S. Cheremnov
Municipal Ivano-Matreninsky Children’s Clinical Hospital
Email: fake@neicon.ru
ORCID iD: 0000-0001-6135-4054
Irkutsk, 664009
РоссияV. A. Stankeev
Irkutsk State Medical University
Email: fake@neicon.ru
ORCID iD: 0000-0002-8759-7887
Irkutsk, 664003
РоссияA. P. Rozhanski
Irkutsk State Medical University
Email: fake@neicon.ru
ORCID iD: 0000-0001-7922-7600
Irkutsk, 664003
РоссияS. Yu. Kozlov
Irkutsk State Medical University
Email: fake@neicon.ru
ORCID iD: 0000-0001-5834-1674
Irkutsk, 664003
РоссияYa. P. Sandakov
Irkutsk State Medical Academy of Continuous Education
Email: fake@neicon.ru
ORCID iD: 0000-0002-3976-9509
Irkutsk, 664049
РоссияReferences
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