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一项关于Santulli肠造口术在新生儿坏死性小肠结肠炎中应用的回顾性队列研究。

A retrospective cohort study of the application of Santulli enterostomy in neonatal necrotizing enterocolitis.

作者信息

Fu Zhe, Zhang Jingmin, Qin Fanyue, Wang Xinru, Huang Hua, Huang Hongwei, Zheng Mingjun, Wang Peng, Zhang Weibo, Shi Hongguang

机构信息

Department of General Surgery, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.

Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.

出版信息

Sci Rep. 2025 Jan 9;15(1):1475. doi: 10.1038/s41598-024-84384-2.

Abstract

The use of Santulli enterostomy (SE) for necrotizing enterocolitis (NEC) has been limited to a small number of studies involving a small number of patients and no control group. Our study aimed to compare the clinical safety and efficacy of Santulli enterostomy with those of single- or double-lumen enterostomy for neonatal NEC through a retrospective cohort study. One hundred ten patients who met the criteria were divided into an SE group (64 patients) and a conventional enterostomy (CE) group (46 patients). The CE group underwent single- or double-lumen enterostomy. There were no significant differences in complication rates or prognoses between the two groups after either procedure. Although the stoma was positioned higher in the SE group, the length of the unused small intestine (USI) was not significantly different. Multivariate analysis revealed that the length of the USI influenced the likelihood of malnutrition after enterostomy (OR = 1.108, P = 0.008). After stoma closure, compared with those in the CE group, the operation time, intestinal recovery time, fasting time, hospitalization time, intraoperative blood loss volume and the incidence of complications requiring surgical reintervention was significantly lower in the SE group. In conclusion, Santulli enterostomy is not only a safe treatment option for NEC but also an effective method for increasing the length of the small intestine after enterostomy, thereby improving the patient's postoperative nutritional status. In addition, the procedure is associated with good recovery and a reduced incidence of surgical reintervention after stoma closure.

摘要

桑图利造口术(SE)用于坏死性小肠结肠炎(NEC)的研究仅限于少数涉及少量患者且无对照组的研究。我们的研究旨在通过回顾性队列研究,比较桑图利造口术与单腔或双腔造口术治疗新生儿NEC的临床安全性和疗效。110例符合标准的患者被分为SE组(64例)和传统造口术(CE)组(46例)。CE组接受单腔或双腔造口术。两种手术后两组的并发症发生率和预后均无显著差异。虽然SE组的造口位置较高,但未使用小肠(USI)的长度无显著差异。多因素分析显示,USI的长度影响造口术后营养不良的可能性(OR = 1.108,P = 0.008)。造口关闭后,与CE组相比,SE组的手术时间、肠道恢复时间、禁食时间、住院时间、术中失血量以及需要再次手术干预的并发症发生率均显著降低。总之,桑图利造口术不仅是治疗NEC的安全选择,也是增加造口术后小肠长度的有效方法,从而改善患者术后营养状况。此外,该手术恢复良好,造口关闭后再次手术干预的发生率降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/76cc/11718129/317e9207432d/41598_2024_84384_Fig1_HTML.jpg

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