Comparative study between window and conventional enterostomies in preterm neonates with small bowel perforations

Area of Science:

• Neonatal surgery
• Pediatric gastroenterology
• Surgical innovation

Background:

• Small bowel perforations in neonates can stem from necrotizing enterocolitis (NEC), ischemic necrosis, or occlusive anomalies.
• Conventional enterostomy (CEnt) is a surgical option, but stoma-related morbidity is a concern.
• Window enterostomy (WEnt) was developed to mitigate stoma-related complications.

Purpose of the Study:

• To describe the window enterostomy (WEnt) technique.
• To compare the outcomes of WEnt versus conventional enterostomy (CEnt) in preterm infants.
• To evaluate WEnt in neonates with focal NEC or isolated small bowel perforation (ISBP).

Main Methods:

• Retrospective review of neonates with NEC or ISBP requiring surgical intervention between January 1996 and March 2006.
• Patients were categorized into WEnt and CEnt groups.
• Data collected included demographics, operative time, need for reoperation, postoperative morbidity, parenteral nutrition duration, and weight gain.

Main Results:

• Twenty-four neonates (14 CEnt, 10 WEnt) were included; median gestational age 25.4 weeks, birth weight 814.4 g.
• Statistically significant differences observed in operative time, duration of total parenteral nutrition, time to full oral feeding, and weekly weight gain between groups.
• The CEnt group experienced a higher rate of postoperative complications compared to the WEnt group.

Conclusions:

• Window enterostomy (WEnt) is a rapid and feasible surgical technique for preterm neonates.
• WEnt is associated with minimal morbidity in neonates undergoing surgery for focal NEC or ISBP.
• The findings suggest WEnt as a potentially superior alternative to conventional enterostomy.