Outcomes of surgical treatment of neonates with intestinal stomas in a regional perinatal center



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Abstract

Introduction. Emergency intestinal surgeries in neonates can lead to stoma formation. Indications for stoming, associated complications and ways to prevent them are being actively discussed. The aim of this study was to analyze results of surgical treatment of neonates with intestinal stomas in a perinatal center for the last 10 years.

Material and methods. 81 children with intestinal obstruction (32), necrotizing enterocolitis (27), meconium ileus (14) and others abdominal pathologies (8) were included into the study. Statistical processing was carried out using the SPSS v.26 package; differences were significant at p-value ≤0.05. Complications were assessed with the Clavien-Dindo Сlassification (CDC).

Results. There were 59 premature infants (72.8%); 32 had body weight below 1000 grams (54.2%). Initially performed: 15 (18.5%) colostomies, 49 (60.5%) enterostomies, 17 (21%) T-anastomoses. A compression clip was put in six children with double-barreled ileostomies. Complications were the following: prolapse (12.3%), skin excoriation (43.2%), bleeding (19.8%), large losses of intestinal chyme (17.3%), liver failure (19.8%), sepsis (17.3%), wound dehiscence (6.2%), adhesive obstruction (16%), necrosis (9.9%) and stenosis (7.4%). 16 (19.7%) patients had no complications. 28 (43%) patients had complications by CDC of grade

Conclusion. If a neonate patient has contraindications to primary anastomosing, double-barreled enterostomy with a compression clip is a safe alternative to it. The enterostomy technique in premature newborns does not increase the rate of complications and mortality. Skin excoriation, increased bleeding from the stoma, and liver failure are most common in neonates with enterostomy.

About the authors

S. D. Ivanov

Siberian State Medical University; Evtushenko Regional Perinatal Center

Author for correspondence.
Email: ivanov_st@mail.ru
ORCID iD: 0000-0001-8439-901X

Stanislav D. Ivanov, MD, post-graduate student in department of pediatric surgery at the Siberian State Medical University; pediatric surgeon at the Evtushenko Regional Perinatal Center

Tomsk, 634050

Россия

G. V. Slizovskij

Siberian State Medical University

Email: fake@neicon.ru
ORCID iD: 0000-0001-8217-5805

Tomsk, 634050

Россия

D. A. Balaganskiy

Evtushenko Regional Perinatal Center

Email: fake@neicon.ru

Tomsk, 634063

Россия

V. G. Pogorelko

Evtushenko Regional Perinatal Center

Email: fake@neicon.ru

Tomsk, 634063

Россия

A. B. Yushmanova

Evtushenko Regional Perinatal Center

Email: fake@neicon.ru

Tomsk, 634063

Россия

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