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Multiple spontaneous small bowel anastomosis in premature infants with multisegmental necrotizing enterocolitis
M S Lessin1, D L Schwartz, C W Wesselhoeft
1Division of Pediatric Surgery, Long Island Jewish Medical Center, Schneider Children's Hospital, New Hyde Park, NY, USA.
Journal of Pediatric Surgery
|February 29, 2000
Summary
Intraluminal stenting in necrotizing enterocolitis (NEC) surgery preserves intestinal length by promoting auto-anastomosis, potentially avoiding stomas and reoperations in NEC patients.
Area of Science:
- Pediatric surgery
- Gastroenterology
- Neonatal care
Background:
- Fulminant necrotizing enterocolitis (NEC) often necessitates extensive bowel resection, leading to short bowel syndrome and complications from multiple stomas.
- Current surgical approaches for NEC can result in significant intestinal length loss and further morbidity with stoma closure.
Observation:
- A novel intraluminal stenting technique without anastomosis was applied to two patients with extensive multisegmental NEC.
- The technique involved resecting necrotic bowel and lining viable segments over a feeding tube, with variations in stoma creation and tube management between patients.
Findings:
- Contrast studies revealed successful auto-anastomosis of intestinal segments in both patients treated with intraluminal stenting.
- One patient achieved full enteral feeding and restored intestinal continuity, while the second experienced feeding intolerance and mortality due to parenteral nutrition complications.
Implications:
- This stenting technique offers a potential strategy to maximize intestinal length in NEC management.
- It may help avoid the need for multiple stomas, reduce complications, and potentially prevent reoperations in NEC survivors.