A Comparative Study Between Santulli Ileostomy and Loop Ileostomy in Neonates With Meconium Ileus

Askarpour, Shahnam; Ayatipour, Amin; Peyvasteh, Mehran; Javaherizadeh, Hazhir

doi:10.1590/0102-672020200003e1538

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…In infants, ostomy opening and closing are often the required steps to treat congenital conditions such as anorectal malformations and Hirschsprung disease (HD), or acquired conditions such as NEC. Several types of intestinal stomas have been described for use in children: end stomas, double-barrel stomas, Nixon's skin bridge stoma, loop stoma, BK, and Santulli stomas 1 , 25 .…”

Section: Discussionmentioning

confidence: 99%

“…Bishop-Koop (BK) ileostomy is a technique designed by Bishop et al in 1957, specifically to treat children with “complicated meconium ileus” 4 . Due to its simplicity, this technique has been employed to treat other conditions other than meconium ileus (MI), such as jejunoileal atresia 23 , 24 , neonatal necrotizing enterocolitis (NEC) 14 , and other types of neonatal intestinal obstruction, allowing for early integration of the distal bowel in the intestinal transit 1 .…”

Section: Introductionmentioning

confidence: 99%

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Bishop-Koop Ostomy Revisited: A “Test-Drive” Intestinal Diversion for Children With Suspected Bowel Dysmotility

Silva

Miranda

FILHO

et al. 2023

ABCD, arq. bras. cir. dig.

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BACKGROUND: Bishop-Koop ileostomy has been widely used in pediatric patients with the intention of including as much bowel as possible in the intestinal transit early in the management of children with meconium ileus and intestinal atresia. In recent years, we have been using it as an alternative to test the distal bowel function before closure of a previously constructed ostomy in selected children with questionable distal bowel motility. AIMS: The aim of this study was to present our experience with this alternative use of the Bishop-Koop ostomy. METHODS: This is a cross-sectional retrospective review of hospital records, combined with a comprehensive literature review. RESULTS: Seven children were included: five had suspected aganglionosis, one had gastroschisis complicated with ileal atresia, and one had a colonic stricture secondary to necrotizing enterocolitis. In this short series of patients, motility of the distal bowel was correctly assessed in six patients and partially correctly assessed in one patient. One patient did not pass stools per anus after the Bishop-Koop, and he was later confirmed to have Hirschsprung disease. Four patients resumed normal evacuation pattern after closure of the Bishop-Koop. One patient had a Bishop-Koop colostomy because of recurrent enterocolitis after a transanal pull-through. Although he evacuated normally while having the colostomy, the diarrhea recurred after the ostomy was closed. An additional patient, with a severe behavioral problem, did not evacuate per anus after her colostomy was transformed in a Bishop-Koop-type ostomy, despite the apparent presence of normal ganglia in the bowel wall. CONCLUSIONS: Data from the present series allow us to affirm that Bishop-Koop-type ostomy is a safe and efficient procedure that can be used to assess distal bowel function before a definitive transit reconstruction, in children with uncertain motility issues.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bishop-Koop Ostomy Revisited: A “Test-Drive” Intestinal Diversion for Children With Suspected Bowel Dysmotility

Silva

Miranda

FILHO

et al. 2023

ABCD, arq. bras. cir. dig.

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“…Santulli reported an increase in survival from 40% to 80% in the surgical management of intestinal atresia ( 3 ). To the best of our knowledge, few reports about Santulli enterostomy have been published since the original series ( 4 – 7 ). Moreover, it has not been widely used since several surgeons have inadequate information about it.…”

Section: Introductionmentioning

confidence: 99%

The safety and effectiveness of Santulli enterostomy in neonatal intestinal conditions

Yue

Yang²,

Cui³

et al. 2023

Front. Pediatr.

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BackgroundAs an end stoma, Santulli enterostomy provides early restoration of intestinal continuity without formal laparotomy. Short amputation of the common limb enables closure on a side to restore anatomic continuity without sacrificing valuable intestine; additionally, the procedure is simple and safe. Most newborns who require enterostomy might benefit from Santulli enterostomy; however, several pediatric surgeons lack information regarding this procedure. Therefore, we have reviewed our experience about Santulli enterostomy and explore the advantages and indications in neonatal intestinal conditions.MethodsThe clinical data of 76 neonates who underwent enterostomywere obtained. The patients were divided into two groups: the Santulli group with 33 cases who underwent Santulli enterostomy, and the control group with 43 cases who underwent double- or single-lumen ostomy. The general data of the two groups were analyzed, and the perioperative/postoperative complications, clinical data and the long-term outcomes were compared.ResultsThere was no difference in the demographic informations, the level of enterostomy, the rate of high-sight stoma, the operative time and bleeding of enterostomy between the two groups. Compared to the control group, the operative time of ostomy closure was less in the Santulli group (53.00 vs. 152.47, P < 0.001). The duration of parenteral nutrition (27.45 vs. 44.56, P = 0.010), the mean interval of initial enterostomy to stomal closure (131.21 vs. 216.42, P < 0.001), and length of stay (46.00 vs. 67.60, P = 0.007) were shorter, while the incidence of postoperative complications and hospitalization costs (11.21 vs. 15.49, P = 0.006) were lower. The Santulli procedure can reduce the morbidity of high output ostomy (2 vs. 10, P = 0.042) and short bowel syndrome (3 vs. 132, P = 0.025), shorten the discrepancy of diameter between the proximal and distal segments, maximize the available intestine, and monitor the movement of the distal bowel. The length of incision was shorter, and the catch-up growth was significantly faster in the Santulli group.ConclusionSantulli enterostomy is a superior procedure in the treatment of neonatal intestinal conditions, in terms of fewer complications, faster catch-up growth, shorter hospitalization time and treatment duration. It should be the procedure of choice in several newborns with intestinal conditions that require ostomy.

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Diagnostics and treatment of meconium ileus in newborns

Piloyan,

Gurskaya,

Dyakonova

2024

RPJ

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Introduction. Meconium ileus is a disease characterized by the formation of thick, viscous meconium in the lumen of the small intestine with the development of low obstructive intestinal obstruction in newborns. Impaired meconium formation in children with cystic fibrosis is associated with a mutation of the CFTR gene, the development of apical dehydration of the secretory epithelium of the intestinal wall and excretory dysfunction of the pancreas. The aim of the review: to identify the leading mechanisms of formation of meconium ileus in newborn children to optimize its treatment. A review of the literature on the topic meconium ileus. In premature newborns, the development of obstructive intestinal obstruction is associated not only with the presence of dense meconium, but also with immaturity of the motor function of the gastrointestinal tract. Hyperechogenic masses in the intestinal lumen, calcifications in the abdominal cavity, dilation of intestinal loops, and free fluid in the abdominal cavity according to prenatal ultrasound indicate a high probability of cystic fibrosis in the fetus, which requires genetic counselling parents. One of the therapeutic and diagnostic methods for meconium ileus is the setting of a hypertensive enema with a water-soluble hyperosmolar contrast agent. This tactic being acceptable for use in simple forms of meconium ileus as a conservative therapy is effective in 25% of cases. Complicated forms of meconium ileus are characterized by the presence of secondary atresia, isolated inversion of the small intestine, severe ischemia or intestinal necrosis. In severe cases, meconium peritonitis develops simultaneously with perforation of the intestinal wall. Surgical methods for the treatment of simple and complicated forms of meconium ileus include washing meconium from the intestine with the imposition of primary anastomosis, alternative low-traumatic operations (enterotomy), as well as various options for stoma operations. However, a protocol for the treatment of meconium ileus has not yet been developed (including patients with cystic fibrosis). Difficulties remain in choosing the method of surgical correction of the meconium ileus of premature infants.

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A Comparative Study Between Santulli Ileostomy and Loop Ileostomy in Neonates With Meconium Ileus

Cited by 3 publications

References 13 publications

Bishop-Koop Ostomy Revisited: A “Test-Drive” Intestinal Diversion for Children With Suspected Bowel Dysmotility

Bishop-Koop Ostomy Revisited: A “Test-Drive” Intestinal Diversion for Children With Suspected Bowel Dysmotility

The safety and effectiveness of Santulli enterostomy in neonatal intestinal conditions

Diagnostics and treatment of meconium ileus in newborns

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