Intraoperative colonic lavage in a premature infant: a case report

Area of Science:

• Pediatric Surgery
• Neonatal Care
• Gastrointestinal Surgery

Background:

• Traditional management of left-sided colonic obstruction in neonates involves multistaged colostomy and resection, associated with significant morbidity.
• Enterostomies in premature infants, particularly for conditions like necrotizing enterocolitis, have reported high complication rates (e.g., 68%).
• One-stage primary anastomosis with on-table antegrade colonic lavage is increasingly used in adults but less established in neonates.

Observation:

• This case report details the modified application of on-table antegrade colonic lavage.
• The technique was used to manage an obstructing sigmoid stricture in a premature infant.
• This represents an adaptation of an adult surgical technique for a neonatal population.

Findings:

• The modified on-table colonic lavage was successfully applied in a premature infant with sigmoid stricture.
• This technique potentially offers an alternative to traditional multistaged surgical approaches.
• The case highlights the feasibility of adapting adult procedures for complex neonatal surgical conditions.

Implications:

• This modified technique may reduce the significant morbidity associated with enterostomies in premature neonates.
• It offers a potential alternative to multistaged surgeries, possibly leading to shorter hospital stays and fewer complications.
• Further investigation and larger studies are warranted to validate the safety and efficacy of this approach in the neonatal population.