Al-Zaiem Maher, Al-Garni Abdulhai F, Al-Maghrebi Abdulrahman, Asghar Asim A
Department of Pediatric Surgery, Maternity and Children Hospital, Mecca, KSA.
J Neonatal Surg. 2016 Oct 10;5(4):46. doi: 10.21699/jns.v5i4.456. eCollection 2016 Oct-Dec.
To evaluate the results of the use of the T-tube ileostomy in neonatal intestinal surgery cases. A retrospective review of sixty two neonates underwent intestinal obstruction surgery by using T-tube ileostomy was conducted between January 1990 and January 2013.The pathologies of the intestinal obstruction were; thirty four of jejunoileal atresia cases, thirteen case meconium ileus, eight cases perforated necrotizing enterocolitis (NEC), three cases meconium peritonitis, three cases with bowel resection due to intestinal volvulus, and one case of gastroschisis. Mean duration of T-tube placement was 13 days (range9-20days) and the sites of T-tube insertion closed spontaneously in 2 days (range 1-4 days). The mean duration for starting oral intake postoperatively in these patients was 9 days (6-16 days). All patients well tolerated the procedure and there were no serious complications related to the T-tube insertion. However, four patients died due to other reasons like sepsis, respiratory failure and prematurity. T-tube enterostomy is an effective and safe technique for treatment of selected cases of neonatal intestinal surgery. It showed less morbidity and mortality rates than the conventional stoma. Therefore, it is considered a helpful approach in cases where there is danger of hypoperistaltic dilated bowel proximal to the anastomosis.
评估T型管回肠造口术在新生儿肠道手术病例中的应用结果。对1990年1月至2013年1月期间62例行T型管回肠造口术治疗肠梗阻的新生儿进行回顾性研究。肠梗阻的病理类型包括：空肠回肠闭锁34例、胎粪性肠梗阻13例、坏死性小肠结肠炎穿孔8例、胎粪性腹膜炎3例、肠扭转行肠切除3例、腹裂1例。T型管放置的平均时间为13天（范围9 - 20天），T型管插入部位在2天内（范围1 - 4天）自行闭合。这些患者术后开始经口进食的平均时间为9天（6 - 16天）。所有患者对该手术耐受性良好，未出现与T型管插入相关的严重并发症。然而，有4例患者因败血症、呼吸衰竭和早产等其他原因死亡。T型管肠造口术是治疗部分新生儿肠道手术病例的一种有效且安全的技术。与传统造口术相比，其发病率和死亡率更低。因此，在吻合口近端存在肠蠕动减弱、肠管扩张风险的病例中，它被认为是一种有用的方法。
