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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 is a superior surgical option for neonates with meconium ileus, demonstrating fewer complications and shorter hospital stays compared to loop ileostomy.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Gastrointestinal Surgery
Background:
- Meconium ileus is a frequent 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 with meconium ileus.
- To identify the optimal surgical approach for managing meconium ileus.
Main Methods:
- Retrospective analysis of 58 neonates diagnosed with meconium ileus.
- Inclusion of 53 patients with complete hospital records for data extraction.
- Collection of demographic, surgical, and postoperative complication data.
Main Results:
- Santulli ileostomy showed significantly lower rates of skin excoriation (21.4% vs. 84%), ostomy prolapse (0% vs. 28%), and surgical site infection (7.1% vs. 28%).
- Ileostomy output was substantially reduced in the Santulli group at week 1 (70.53±15.11 ml vs. 144.6±19.99 ml) and week 4 (2.14±4.98 ml vs. 18.4±17.95 ml).
- Hospital stay was shorter for Santulli ileostomy (12±2.34 days) compared to loop ileostomy (14.24±1.47 days).
Conclusions:
- Santulli ileostomy offers significant advantages over loop ileostomy for treating meconium ileus in neonates.
- The Santulli technique results in reduced surgical site infections, skin excoriation, and ostomy prolapse.
- Improved ileostomy output and decreased hospitalization time favor the Santulli ileostomy approach.
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.
