Rygl M, Pycha K, Stranak Z, Skaba R, Brabec R, Cunat V, Snajdauf J
Department of Pediatric Surgery, 2nd Faculty of Medicine and Teaching Hospital in Motol, Institute of Postgraduate Medicine, Charles University, V Uvalu 84, Prague 5, Czech Republic.
Pediatr Surg Int. 2007 Jul;23(7):685-8. doi: 10.1007/s00383-007-1931-9. Epub 2007 May 8.
To evaluate the results of use of T-tube ileostomy in selected cases of intestinal perforation in extremely low birth weight (ELBW) neonates. The records of 288 ELBW neonates treated at author's institution, from 1998 to 2003 were retrospectively reviewed to identify neonates operated for intestinal perforation with T-tube placement. T-tube was inserted into the bowel through the site of perforation or proximally to the perforated gut via separate stab incision. T-tubes were used in five ELBW neonates (BW 600-900 g, gestational age 25-27 weeks) with intestinal perforation, in four of them at the time of primary surgery and in one neonate 8 days after primary anastomosis. All patients survived and there were no serious complications related to the T-tube insertion. Median duration of T-tube placement was 4 weeks (range 3-8 weeks), full enteral feeding after T-tube insertion was achieved in 4 weeks (range 1-6 weeks). All sites of T-tube insertion closed spontaneously. T-tube ileostomy is an effective and safe technique for treatment of selected cases of intestinal perforation in ELBW neonates. With respect to the hypoperistalsis of immature bowel, we recommend the use of T-tube in all cases of isolated intestinal perforation in ELWB neonates.
评估在极低出生体重（ELBW）新生儿的某些肠穿孔病例中使用T型管回肠造口术的结果。回顾性分析了1998年至2003年在作者所在机构接受治疗的288例ELBW新生儿的记录，以确定接受肠穿孔手术并放置T型管的新生儿。T型管通过穿孔部位插入肠道，或通过单独的戳孔切口插入穿孔肠段的近端。5例ELBW新生儿（体重600 - 900克，胎龄25 - 27周）肠穿孔时使用了T型管，其中4例在初次手术时使用，1例在初次吻合术后8天使用。所有患者均存活，且未出现与T型管插入相关的严重并发症。T型管放置的中位时间为4周（范围3 - 8周），T型管插入后4周（范围1 - 6周）实现了完全肠内喂养。T型管插入的所有部位均自行闭合。T型管回肠造口术是治疗ELBW新生儿某些肠穿孔病例的一种有效且安全的技术。鉴于未成熟肠道蠕动功能减弱，我们建议在ELWB新生儿所有孤立性肠穿孔病例中使用T型管。
