Martynov Illya, Raedecke Jochen, Klima-Frysch Jessica, Kluwe Wolfram, Schoenberger Joachim
Department of Pediatric Surgery, University of Leipzig, Leipzig.
Department of Pediatric Surgery, University Hospital of Freiburg, Freiburg, Germany.
Medicine (Baltimore). 2019 Jul;98(27):e16304. doi: 10.1097/MD.0000000000016304.
To determine the potential value and suitability of Bishop-Koop procedure (BK) compared to divided stoma (DS) in neonates with meconium ileus (MI), congenital intestinal atresia (CIA), and necrotizing enterocolitis (NEC).A retrospective data collection from 2000 to 2019 on neonates undergoing BK and DS formation and closure for MI, CIA, and NEC was conducted. Ostomy related complications following both procedures were analyzed.One hundred two consecutive patients managed with a BK (n = 57, 55.8%) and DS (n = 45, 44.2%) for MI (n = 38, 37.2%), CIA (n = 31, 30.5%), and NEC (n = 33, 32.3%) were analyzed. Mean operating time for ostomy creation did not differ significantly between BK and DS groups (156 ± 54 vs 135 ± 66.8 min, P = .08). The prevalence of stoma-related complications following BK and DS formation was 8.7% and 31.1%, respectively (P = .005). The complication rate after BK and DS closure was 3.5% and 6.7%, respectively (P = .65). The operating time for ostomy reversal and length of hospital stay after stoma closure were significantly shorter in BK group (82.2 ± 51.4 vs 183 ± 84.5 min and 5.5 ± 2.7 vs 11.3 ± 3.9 days, P < .001).BK procedure is safe, reliable, and suitable technique in neonatal surgery with low complications rate following ostomy creation as well as shorter operating time and length of hospital stay after ostomy closure compared to DS ostomies. Surgeons should keep this technique as an alternative approach in their repertoire.
为确定在患有胎粪性肠梗阻(MI)、先天性肠闭锁(CIA)和坏死性小肠结肠炎(NEC)的新生儿中,与造口分流术(DS)相比,毕肖普 - 库普手术(BK)的潜在价值和适用性。对2000年至2019年期间接受BK和DS造口及关闭手术治疗MI、CIA和NEC的新生儿进行了回顾性数据收集。分析了两种手术术后与造口相关的并发症。对连续102例接受BK(n = 57,55.8%)和DS(n = 45,44.2%)治疗的MI(n = 38,37.2%)、CIA(n = 31,30.5%)和NEC(n = 33,32.3%)患者进行了分析。BK组和DS组造口创建的平均手术时间无显著差异(156 ± 54 vs 135 ± 66.8分钟,P = 0.08)。BK和DS造口形成后与造口相关并发症的发生率分别为8.7%和31.1%(P = 0.005)。BK和DS关闭术后的并发症发生率分别为3.5%和6.7%(P = 0.65)。BK组造口回纳的手术时间和造口关闭后的住院时间显著更短(82.2 ± 51.4 vs 183 ± 84.5分钟以及5.5 ± 2.7 vs 11.3 ± 3.9天,P < 0.001)。与DS造口相比,BK手术在新生儿手术中是一种安全、可靠且适用的技术,造口创建后并发症发生率低,造口关闭后的手术时间和住院时间更短。外科医生应将此技术作为其手术方法中的一种替代选择。