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New technique for enterostomy of extremely low-birth-weight infants--intestinal anchoring with gauze
Kazuhiro Kondo1, Kazuo Chijiiwa, Motoi Mukai
1Department of Surgical Oncology and Regulation of Organ Function, Miyazaki University School of Medicine, Miyazaki 889-1692, Japan.
Insights
A novel gauze-based intestinal anchoring technique simplifies enterostomy for extremely low-birth-weight infants. This method proves effective, with a high survival rate and manageable complications in neonates weighing less than 1000 grams.
Area of Science:
- Neonatal Surgery
- Pediatric Surgery
- Gastrointestinal Surgery
Background:
- Enterostomy in extremely low-birth-weight infants (<1000 g) presents surgical challenges due to the small, fragile intestine.
- Conventional intestinal anchoring techniques are difficult to apply in this vulnerable population.
Purpose of the Study:
- To describe and evaluate a novel technique for intestinal anchoring during enterostomy in extremely low-birth-weight infants.
- To assess the efficacy and safety of gauze-based intestinal anchoring.
Main Methods:
- A technique using a gauze strip packed into the subcutaneous space for intestinal anchoring without sutures was employed.
- The method was applied to 21 infants weighing less than 1000 g with intestinal perforation or obstruction.
Main Results:
- Two patients (9.5%) experienced complications, including parastomal and intrastomal intestinal prolapse, successfully managed by reoperation.
- Eighteen patients (86%) survived the procedure and achieved successful enterostoma closure.
Conclusions:
- Gauze-based intestinal anchoring is an easy and effective method for enterostomy in extremely low-birth-weight infants.
- This technique is suitable for selected cases requiring enterostomy in neonates weighing less than 1000 g.
Background:
In enterostomy for extremely low-birth-weight infants (<1000 g), the technique of anchoring the intestine for a stoma to the abdominal wall is very difficult because of the small size and fragile nature of the intestine. Here we describe a novel technique for intestinal anchoring in such infants.
Methods:
In our approach to enterostomy, the intestine is anchored only by a strip of gauze packed into the subcutaneous space. No suturing is performed. The efficacy of this technique was evaluated in 21 infants with less than 1000 g of body weight who have intestinal perforation or obstruction.
Results:
Two patients (9.5%) had complications that were related to the enterostomy. The complications were parastomal and intrastomal intestinal prolapse, both of which were treated successfully by reoperation. Eighteen patients (86%) survived to closure of the enterostoma.
Conclusions:
Intestinal anchoring with gauze is an easy and effective technique for enterostomy in extremely low-birth-weight infants and can be applied in selected cases.
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