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Updated: Sep 2, 2025
Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Comparison of Outcomes between Two Surgical Techniques for Patients with Intestinal Neuronal Dysplasia
Yu Lin1, Dianming Wu1, Yong Shen1
1Pediatric Surgery Department, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350000 Fujian, China.
Insights
The Santulli stoma is a more effective surgical option for children with intestinal neuronal dysplasia (IND) than the double-lumen ileum stoma. This approach promotes better growth, reduces hospitalizations for dehydration, and lowers overall costs.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Congenital Malformations
Background:
- Hirschsprung disease (HSCR) is a severe congenital intestinal disorder affecting 1 in 5000 newborns.
- It necessitates complex surgical interventions in affected children.
- Intestinal neuronal dysplasia (IND) is a related condition impacting bowel motility.
Purpose of the Study:
- To compare the clinical outcomes of the ileal Santulli stoma versus the ileal double-lumen stoma in children with IND.
- To evaluate the efficacy of these surgical techniques in managing intestinal obstruction and related complications.
Main Methods:
- A retrospective analysis of 23 children diagnosed with IND and treated for intestinal obstruction between 2014 and 2019.
- Patients were categorized into two groups based on the type of ileal fistula created: Santulli stoma (10 cases) and double-lumen stoma (13 cases).
- Comparison of body weight at the second-stage surgery, hospitalization rates for enteritis and dehydration, and economic costs.
Main Results:
- No significant differences in baseline data or fistula location were observed between the groups.
- The Santulli stoma group showed a significantly higher fistula precursor weight (P < 0.05).
- The Santulli stoma group experienced a shorter interval between surgeries, fewer hospitalizations for enteritis and dehydration, and lower economic costs (P < 0.05).
Conclusions:
- The ileal Santulli stoma demonstrates superior clinical effectiveness compared to the double-lumen ileum stoma for children with IND.
- This technique supports improved post-operative growth and development.
- It also leads to reduced treatment duration, fewer dehydration episodes, and decreased financial burden on families, warranting clinical adoption.
Objective:
Hirschsprung disease (HSCR) is a serious congenital intestinal disease with a prevalence of 1/5000. HSCR remains one of the most severe congenital malformations of the abdominal organs in children that require complex reconstructive surgery. This study is aimed at investigating the clinical analysis of ileal Santulli stoma and ileal double-lumen stoma in children diagnosed with intestinal neuronal dysplasia (IND).
Methods:
Retrospective analysis was performed on the children who were admitted to our hospital for intestinal obstruction from January 2014 to January 2019, underwent fistula operation and fistula closure operation, and were diagnosed with IND. According to the different modes of fistula, the children were divided into ileal Santulli stoma group and ileal double-lumen stoma group. The body weight of the children in the two groups during the second stage of fistula closure operation was compared. The number of hospitalizations due to enteritis and dehydration during the two operations was compared.
Results:
A total of 23 cases (12 males and 11 females) were included in this study, including 10 cases in the Santulli group and 13 cases in the ileal double-lumen stoma group. There were no significant differences in baseline data and fistula location between the two groups. Compared with the ileal double-lumen stoma group, the Santulli stoma group had significantly higher weight of fistula precursor (P < 0.05), the interval between two operations was shorter (P < 0.05), there is less hospitalization for enteritis and dehydration during the two operations (P < 0.05), and there is less economic cost after fistula (P < 0.05).
Conclusion:
The clinical effect of ileum Santulli fistula is significantly better than double-lumen ileum fistula, which is not only beneficial to the growth and development of children after the first fistula but also can shorten the time of fistula closure, reduce the incidence of dehydration, and reduce the economic burden of family members. Therefore, it is worthy of clinical promotion and application.
