Steiner Z, Mogilner J, Siplovich L, Eldar S
Department of Pediatric Surgery, Bnai-Zion Medical Center, P. O. B. 4940, Haifa, 31048 Israel
Pediatr Surg Int. 1997 Mar 21;12(2/3):140-1.
Fifteen cases of meconium ileus (MI) were treated between 1986 and 1995; 7 responded to conservative treatment. Eight were operated upon, and comprise the study group. Six of the operated babies had no complications; 1 had meconium peritonitis with a pseudocyst and small-bowel atresia, and 1 had a volvulus of a small-bowel segment with necrosis. In all 8 cases a T-tube (TT) was left via an enterotomy; in the complicated cases the enterotomy was pre-anastomotic. The obstruction was relieved in all the babies, without any stoma or bowel resection in the uncomplicated cases. Two complications occurred: 1 patient died of respiratory failure 1 month following surgery and another required a relaparotomy for lysis of adhesions. We conclude that TT ileostomy is an effective and safe procedure for uncomplicated cases of MI that do not respond to conservative therapy, as well as for complicated cases that need an anastomosis.
1986年至1995年间共治疗了15例胎粪性肠梗阻（MI）；7例对保守治疗有反应。8例行手术治疗，组成研究组。6例接受手术的婴儿无并发症；1例有胎粪性腹膜炎伴假性囊肿和小肠闭锁，1例有小肠段扭转伴坏死。所有8例均经肠切开留置T管（TT）；在复杂病例中，肠切开位于吻合口前。所有婴儿的梗阻均得到缓解，非复杂病例未行造口或肠切除。发生了2例并发症：1例患者术后1个月死于呼吸衰竭，另1例因粘连松解需再次剖腹手术。我们得出结论，TT回肠造口术对于对保守治疗无反应的非复杂MI病例以及需要吻合的复杂病例是一种有效且安全的手术方法。
