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The Santulli enterostomy in necrotising enterocolitis.
K Vanamo1, R Rintala, H Lindahl
1Department of Pediatric Surgery 2206, Kuopio University Hospital, 70211 Kuopio, Finland. kari.vanamo@kuh.fi
Pediatric Surgery International
|September 17, 2004
Summary
The Santulli enterostomy is a viable surgical option for necrotising enterocolitis (NEC) in premature infants, enabling early intestinal continuity restoration. While effective, this procedure is technically challenging and associated with significant patient morbidity.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Gastrointestinal Surgery
Background:
- Necrotising enterocolitis (NEC) presents significant surgical challenges in neonates.
- Current surgical options for NEC often fail to meet all ideal criteria, including speed, reliability, and minimizing intestinal loss.
- The Santulli enterostomy is evaluated as a potential solution for NEC management.
Purpose of the Study:
- To review the experience with Santulli enterostomy in the surgical management of Bell grade III necrotising enterocolitis.
- To assess the efficacy, complications, and outcomes of the Santulli enterostomy procedure in neonates.
Main Methods:
- Retrospective review of 19 patients with Bell grade III NEC who underwent Santulli enterostomy between 1992 and 1998.
- Analysis of patient demographics, operative details, complications, and short-term outcomes including feeding, hospital stay, and subsequent procedures.
Main Results:
- The Santulli enterostomy was performed on 19 neonates (median gestational age 26 weeks, median birth weight 755g).
- A survival rate of 84% was observed, with complications including anastomosis leakage, stomal necrosis, and intestinal obstruction.
- Early enteral feeding was initiated postoperatively, with a median time to enterostomy closure of 48 days and a median hospital stay of 87 days.
Conclusions:
- Santulli enterostomy is a feasible surgical approach for necrotising enterocolitis, even in extremely premature infants.
- The procedure facilitates rapid restoration of intestinal continuity and allows for early stomal closure.
- Despite its benefits, the Santulli enterostomy is technically demanding and associated with considerable morbidity, requiring careful consideration in patient selection and surgical execution.