新生儿胎粪性肠梗阻中Santulli回肠造口术与袢式回肠造口术的比较研究

A comparative study between Santulli ileostomy and loop ileostomy in neonates with meconium ileus.

作者信息

Askarpour Shahnam, Ayatipour Amin, Peyvasteh Mehran, Javaherizadeh Hazhir

机构信息

Pediatric Surgery.

Pediatric Gastroenterology and Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Khouzestan, Iran.

出版信息

Arq Bras Cir Dig. 2020 Nov 13;33(1):e1485. doi: 10.1590/0102-672020190001e1485. eCollection 2020.

DOI:10.1590/0102-672020190001e1485

PMID:33206844

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7668294/

Abstract

BACKGROUND

Meconium ileus is a common cause of intestinal obstruction in neonates that different surgical methods have been described for its management such as Santulli and loop ileostomy.

AIM

To evaluate and compare clinical efficacy of Santulli and loop ileostomy in neonates with meconium ileus.

METHODS

In this retrospective study, 58 patients with meconium ileus were evaluated. After analyses of hospital records, 53 patients with completed hospital records were included. Demographic information, surgery parameters and postoperative complications were extracted from the hospital records or calling parents.

RESULTS

Skin excoriation (21.4% vs. 84%, p<0.001), ostomy prolapsed (0 vs. 28%, p=0.003), and surgical site infection (7.1% vs. 28%, p=0.044) was significantly lower in Santulli ileostomy group. Furthermore, ileostomy output in first week (70.53±15.11 ml vs. 144.6±19.99 ml, p<0.001) and in 4th week (2.14±4.98 ml vs. 18.4±17.95 ml, p<0.001) was significantly lower in Santulli ileostomy group as compared to loop ileostomy group. Finally, hospital stay in Santulli ileostomy group was 12±2.34 and in loop ileostomy 14.24±1.47 days (p<0.001).

CONCLUSION

Santulli ileostomy is better than loop ileostomy due to significant less frequency of surgical site infection, skin excoriation, prolapse of ostomy, ileostomy volume output and hospitalization time.

摘要

背景

胎粪性肠梗阻是新生儿肠梗阻的常见原因，针对其治疗已描述了不同的手术方法，如桑图利手术和袢式回肠造口术。

目的

评估并比较桑图利手术和袢式回肠造口术治疗新生儿胎粪性肠梗阻的临床疗效。

方法

在这项回顾性研究中，对58例胎粪性肠梗阻患者进行了评估。经分析医院记录后，纳入了53例有完整医院记录的患者。从医院记录或致电家长获取人口统计学信息、手术参数和术后并发症。

结果

桑图利回肠造口术组的皮肤擦伤（21.4%对84%，p<0.001）、造口脱垂（0对28%，p=0.003）和手术部位感染（7.1%对28%，p=0.044）显著更低。此外，与袢式回肠造口术组相比，桑图利回肠造口术组第一周（70.53±15.11毫升对144.6±19.99毫升，p<0.001）和第四周（2.14±4.98毫升对18.4±17.95毫升，p<0.001）回肠造口排出量显著更低。最后，桑图利回肠造口术组的住院时间为12±2.34天，袢式回肠造口术组为14.24±1.47天（p<0.001）。