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一种用于小肠闭锁新生儿小肠造口构建的微小创新以降低发病率。

A Minor Innovation in Constructing a Small Bowel Stoma in Neonates with Small Bowel Atresia to Reduce the Morbidity.

作者信息

Khan Naeem, Bakht Saba, Zaheer Nadia

机构信息

KRL General Hospital, G-9/1, Mauve Area, Islamabad.

IBM S.P.A Italia, Islamabad, Pakistan.

出版信息

J Neonatal Surg. 2016 Oct 10;5(4):45. doi: 10.21699/jns.v5i4.474. eCollection 2016 Oct-Dec.

Abstract

BACKGROUND

Intestinal atresia has still significant morbidity in developing countries. Stomas are now not recommended in every case of intestinal atresia; primary anastomosis is the goal of surgery after resection of dilated adynamic gut. A new type of stoma formation along with primary anastomosis is being presented here.

MATERIALS AND METHODS

This report is based on our experience of many cases with this technique in last 12 years but all the details and long follow-up of each case is not available. However the method of surgical procedure, progress, complications, and advantages encountered have been highlighted.

RESULTS

Presently we have data of 7 patients; others are lost to follow up. Three had died with other associated problems, namely one with multiple atresias, two with septic shock and prematurity. Two stomas did not require formal closure because stoma shriveled and disappeared. Two other stomas had grown very long like a diverticulum when these were closed after 5 and 8 months.

CONCLUSION

This technique is another attempt to decrease morbidity of patients of intestinal atresia especially in those cases where short bowel syndrome is feared after resection of proximal dilated gut.

摘要

背景

在发展中国家,肠闭锁的发病率仍然很高。现在并非每例肠闭锁患者都建议行造口术;切除扩张无动力肠段后,一期吻合是手术的目标。本文介绍一种新型造口形成术联合一期吻合术。

材料与方法

本报告基于我们过去12年中应用该技术的多例经验,但并非所有病例的详细信息和长期随访资料都可获取。然而,已重点介绍了手术步骤、进展、并发症及所遇到的优势。

结果

目前我们有7例患者的数据;其他患者失访。3例因其他相关问题死亡,其中1例有多发性闭锁,2例因感染性休克和早产死亡。2例造口无需正式关闭,因为造口萎缩消失。另外2例造口在5个月和8个月后关闭时,已长得像憩室一样长。

结论

该技术是降低肠闭锁患者发病率的又一次尝试,尤其适用于那些担心切除近端扩张肠段后会出现短肠综合征的病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9cbe/5117268/9b9046b6b078/jns-5-45.f1.jpg

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