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Gastrointestinal tube stent plication in infants and children
Insights
Gastrointestinal tube stent plication effectively treated intestinal obstruction in 20 pediatric patients, with 90% survival. This method offers a useful solution for recurrent adhesive intestinal obstruction in children.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Intestinal obstruction is a significant surgical challenge in infants and children.
- Recurrent adhesive intestinal obstruction, often following multiple abdominal surgeries, presents complex management issues.
Purpose of the Study:
- To evaluate the efficacy of gastrointestinal tube stent plication in managing intestinal obstruction in pediatric patients.
- To assess the safety and outcomes of this adjunctive procedure.
Main Methods:
- Twenty pediatric patients with intestinal obstruction underwent gastrointestinal tube stent plication.
- A gastrostomy tube was inserted and advanced distally into the colon for ten days.
- Parenteral alimentation was provided, and patency confirmed by barium tubogram before tube removal.
Main Results:
- The mean age of patients was 2.6 years, with 50% being infants.
- Eighteen out of twenty patients (90%) survived the procedure.
- Complete relief of intestinal obstruction was achieved in all treated cases.
Conclusions:
- Gastrointestinal tube stent plication is a valuable adjunctive treatment for carefully selected pediatric cases of recurrent adhesive intestinal obstruction.
- The procedure demonstrates a high success rate and favorable survival outcomes in this cohort.
Abstract:
Twenty cases of intestinal obstruction in infants and children were managed by gastrointestinal tube stent plication. The mean age was 2.6 years, and ten patients were infants. Previous (often multiple) abdominal operations were performed in 18 patients with a variety of anomalies. Tube plication was used at initial operation in two neonates with malrotation. Following lysis of adhesions, a No. 12 or No. 16 tube (usually a Baker tube) was inserted by gastrostomy and advanced distally into the colon. The tube was kept in place for ten days, with caloric needs supplied by parenteral alimentation. Barium tubogram showed distal patency, and the tube was removed. Eighteen patients survived (90%), and obstruction was relieved in each instance. These observations suggest that gastrointestinal tube stent plication is a useful adjunctive procedure in carefully selected cases or recurrent adhesive intestinal obstruction in infants and children.