T-tube enterostomy in neonates with perforated necrotizing enterocolitis as an alternative option

Authors

  • Tarek Talaat Harb Elkadi Department of Paediatric Surgery, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt

DOI:

https://doi.org/10.18203/2349-2902.isj20200280

Keywords:

Enterocolitis, Enterostomy, Tube

Abstract

Background: The use of T tube enterostomy (TTES) as an alternative option for stoma in neonatal emergency is known long time ago.

Methods: We introduced T-tube ileostomy as technical innovation in our institution as a way of treatment for intestinal perforation in low birth weight premature neonates.

Results: In this study 14 neonates underwent TTES procedures at university-based pediatric surgery and neonatology department. 11 (78.6%) patients treated with TTES, discharged home. Three babies (22.4%) died in postoperative course. One of them developed recurrent severe fulminant NEC ileostomy was created and kept on TPN but died after 2 weeks due to septicaemia. The two others were dysmorphic with metabolic diseases.

Conclusions: T tube is effective in selected cases of necrotizing enterocolitis (NEC) because of its simplicity in application and removal. But it could not replace the formal stoma in general, its advantages are saving one more time exposure to surgery in those risky patients, Author recommend the use it in cases of post NEC intestinal perforation and extreme low birth weight neonates.

Author Biography

Tarek Talaat Harb Elkadi, Department of Paediatric Surgery, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt

Associate professor of pediatric surgery

References

Meier DE, Ahmeti M. Peritoneal drainage for newborn intestinal perforation: primary treatment or unnecessary delay?. Ann Pediatr Surg. 2013;9(2):54-7.

Boston VE. Necrotising enterocolitis and localised intestinal perforation: different diseases or ends of a spectrum of pathology. Pediatr Surg Int. 2006;22(6):477-84.

Błaszczyński MI, Porzucek W, Becela P, Gadzinowski JA. T-tube enterostomy in surgical management of emergency cases in neonate. Arch Perinat Med. 2011;17:93-6.

Harberg FJ, Senekjian EK, Pokorny WJ. Treatment of uncomplicated meconium heus via T-tube ileostomy. J Pediatr Surg. 1981;16(1):61-3.

Imran M, Rehman HU, Rehman IU, Waheed T, Khan I. Outcome of bishop koop procedure in neonatal jejunoileal atresias: a retrospective analysis. Kust Medi J. 2011;3(2):52-6.

De Carli C, Ojeda M, Veloce D, González M. T-tube enterostomy for the management of complicated high jejunal atresia. An innovative procedure for complex intestinal entity. A technical report. J Pediatr Surg Case Reports. 2016;7:39-42.

Rouzrokh M, Tavassoli A, Mirshemirani A, Azimi P, Mohajerzadeh L, Shamshiri A. The role of routine transanastomotic T tube ostomy in jejunoilealatresia: A prospective, randomized study. Iranian J PediatR Surg. 2015;1(1):5.

Rygl M, Pycha K, Stranak Z, Skaba R, Brabec R, Cunat V, et al. T-tube ileostomy for intestinal perforation in extremely low birth weight neonates. Pediatric Surg Int. 2007;23(7):685-8.

Pumberger W, Mayr M, Kohlhauser C, Weninger M. Spontaneous localized intestinal perforation in very-low-birth-weight infants:: a distinct clinical entity different from necrotizing enterocolitis. J Am Col Surg. 2002;195(6):796-803.

Tarrado X, Castanon M, Thio M, Valderas JM, Aparicio LG, Morales L. Comparative study between isolated intestinal perforation and necrotizing enterocolitis. Eur J Pediatr Surg. 2005;15(02):88-94.

Cass DL, Brandt ML, Patel DL, Nuchtern JG, Minifee PK, Wesson DE. Peritoneal drainage as definitive treatment for neonates with isolated intestinal perforation. J Pediatr Surg. 2000;35(11):1531-6.

Chwals WJ, Blakely ML, Cheng A, Neville HL, Jaksic T, Cox Jr CS, et al. Surgery-associated complications in necrotizing enterocolitis: a multiinstitutional study. J Pediatr Surg. 2001;36(11):1722-4.

Tam AL, Camberos A, Applebaum H. Surgical decision making in necrotizing enterocolitis and focal intestinal perforation: predictive value of radiologic findings. J Pediatr Surg. 2002;37(12):1688-91.

Vanamo K, Rintala R, Lindahl H. The Santulli enterostomy in necrotising enterocolitis. PediatrSurg Int. 2004;20(9):692-4.

Singh M, Owen A, Gull S, Morabito A, Bianchi A. Surgery for intestinal perforation in preterm neonates: anastomosis vs stoma. J Pediatr Surg. 2006;41(4):725-9.

Al-Zaiem M, AL-Garni AF, Al-Maghrebi A, Asghar AA. Use of T-Tube Enterostomy in Neonatal Gastro-intestinal Surgery. J Neonat Surg. 2016;5(4):46.

Wakahara T, Kaji M, Harada Y, Tsuchida S, Toyokawa A. Intestinal perforation management using T-tube drainage. J Surgic Case Reports. 2016;2016(5):rjw085.

Bælum JK, Rasmussen L, Qvist N, Ellebæk MB. Enterostomy complications in necrotizing enterocolitis (NEC) surgery, a retrospective chart review at Odense University Hospital. BMC Pediatr. 2019;19(1):110.

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Published

2020-01-27

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Original Research Articles