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A comparative study between Santulli ileostomy and loop ileostomy in neonates with meconium ileus
Shahnam Askarpour1, Amin Ayatipour1, Mehran Peyvasteh1
1Pediatric Surgery.
Insights
Santulli ileostomy shows superior outcomes for neonates with meconium ileus compared to loop ileostomy. This surgical approach significantly reduces complications and hospitalization time.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Gastrointestinal Surgery
Background:
- Meconium ileus is a primary cause of intestinal obstruction in newborns.
- Surgical management options include Santulli and loop ileostomy.
Purpose of the Study:
- To compare the clinical effectiveness of Santulli ileostomy versus loop ileostomy in neonates diagnosed with meconium ileus.
Main Methods:
- A retrospective analysis of 58 neonates with meconium ileus was conducted.
- Hospital records of 53 patients were reviewed for demographic data, surgical details, and postoperative complications.
Main Results:
- The Santulli ileostomy group exhibited significantly lower rates of skin excoriation (21.4% vs. 84%), ostomy prolapse (0% vs. 28%), and surgical site infections (7.1% vs. 28%).
- Ileostomy output and hospitalization duration were also substantially reduced in the Santulli ileostomy group.
- Santulli ileostomy patients averaged 12 days of hospitalization, compared to 14.24 days for loop ileostomy patients.
Conclusions:
- Santulli ileostomy demonstrates superior efficacy over loop ileostomy for managing meconium ileus in neonates.
- The Santulli technique leads to fewer complications, reduced stoma output, and shorter hospital stays.
Background:
Meconium ileus is a common cause of intestinal obstruction in neonates that different surgical methods have been described for its management such as Santulli and loop ileostomy.
Aim:
To evaluate and compare clinical efficacy of Santulli and loop ileostomy in neonates with meconium ileus.
Methods:
In this retrospective study, 58 patients with meconium ileus were evaluated. After analyses of hospital records, 53 patients with completed hospital records were included. Demographic information, surgery parameters and postoperative complications were extracted from the hospital records or calling parents.
Results:
Skin excoriation (21.4% vs. 84%, p<0.001), ostomy prolapsed (0 vs. 28%, p=0.003), and surgical site infection (7.1% vs. 28%, p=0.044) was significantly lower in Santulli ileostomy group. Furthermore, ileostomy output in first week (70.53±15.11 ml vs. 144.6±19.99 ml, p<0.001) and in 4th week (2.14±4.98 ml vs. 18.4±17.95 ml, p<0.001) was significantly lower in Santulli ileostomy group as compared to loop ileostomy group. Finally, hospital stay in Santulli ileostomy group was 12±2.34 and in loop ileostomy 14.24±1.47 days (p<0.001).
Conclusion:
Santulli ileostomy is better than loop ileostomy due to significant less frequency of surgical site infection, skin excoriation, prolapse of ostomy, ileostomy volume output and hospitalization time.
