Double-barreled enterostomy with compression anastomosis in newborns and infants
- Authors: Ivanov S.D.1,2,3, Slizovskiy G.V.1, Shikunova Y.V.1, Pogorelko V.G.2,3, Balaganskiy D.A.1,2, Yushmanova A.B.2,3, Gunther V.E.4, Khodorenko V.N.4, Anikeev S.G.4
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Affiliations:
- Siberian State Medical University
- I.D. Evtushenko Regional Perinatal Center
- Emergency Hospital No. 2
- Research Institute of Medical Materials and Implants with Shape Memory of Siberian physical-technical institute – Tomsk State Uuiversity
- Issue: Vol 11, No 4 (2021)
- Pages: 463-474
- Section: Original Study Articles
- URL: https://journal-vniispk.ru/2219-4061/article/view/123528
- DOI: https://doi.org/10.17816/psaic1007
- ID: 123528
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Abstract
BACKGROUND: Staged treatment of small bowel diseases involves the formation of an enterostomy. Bishop–Koop T-anastomosis and Mikulicz double-barreled enterostomy with compression clamp are widely applied. The disadvantages of Mikulicz’s can be eliminated using a clip of titanium nickelide with shape memory instead of a clamp.
AIM: This study aimed to evaluate the efficacy and safety of a titanium nickelide device in double-barreled enterostomy and compare the results of treatment with a T-anastomosis.
MATERIALS AND METHODS: The study included newborns and infants. The clip was applied on 9–58 days postoperatively. Differences were accepted as significant at p < 0.05.
RESULTS: Since 2000, enterostomy was performed in 79 children: 12 (15.2%) had T-anastomoses, 44 (55.7%) had double-barreled stomas, and 18 (40.9%) had a titanium nickelide clip. In the study groups, stomas were applied for ileus, atresia, and aganglionosis. In the group of double-barreled enterostomies with a clip, the stoma was closed later (p = 0.027) and the operation time was short (p = 0.013). In the T-anastomosis group, parenteral nutrition was required for a longer period (p = 0.018). Self-removal of the clip and appearance of the stool occurred on days 5 and 1–3. Compression anastomosis was obtained in 83.3% and stoma closure outside in 73.3%. With a double-barreled enterostomy, hepatic failure (p = 0.018) and anastomosis dysfunction (p = 0.046) were less common. T-anastomosis revealed an increase in the incidence of CDC II (p = 0.013) and III (p = 0.015) complications.
DISCUSSION: The results reflect the safety of the presented method in comparison with the T-anastomosis, since the operation time and duration of the parenteral nutrition are reduced, invasive treatment is less often required for complications, and anastomosis dysfunction rarely occurs.
CONCLUSIONS: Double-barreled enterostomy with a compression clip is an effective and safe alternative to T-anastomosis in children aged <1 year. The formed compression anastomosis allows closure of the stoma by suturing its outer part. The conditions for the formation of the anastomosis are the patency of the distal sections and bowel diameter ≥1 cm.
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##article.viewOnOriginalSite##About the authors
Stanislav D. Ivanov
Siberian State Medical University; I.D. Evtushenko Regional Perinatal Center; Emergency Hospital No. 2
Email: ivanov_st@mail.ru
ORCID iD: 0000-0001-8439-901X
SPIN-code: 2839-2810
Scopus Author ID: 57207574392
ResearcherId: ABD-7468-2020
Pediatric Surgeon, Postgraduate Student
Russian Federation, 2 Moskovsky trakt st., Tomsk, 634050; Tomsk; TomskGrigoriy V. Slizovskiy
Siberian State Medical University
Author for correspondence.
Email: sgv5858@mail.ru
ORCID iD: 0000-0001-8217-5805
SPIN-code: 1653-0653
Dr. Sci. (Med.), Professor
Russian Federation, 2 Moskovsky trakt st., Tomsk, 634050Yana V. Shikunova
Siberian State Medical University
Email: yana-z@mail.ru
ORCID iD: 0000-0002-7288-6678
SPIN-code: 4456-5278
Cand. Sci. (Med.), Assistant Professor
Russian Federation, 2 Moskovsky trakt st., Tomsk, 634050Vladimir G. Pogorelko
I.D. Evtushenko Regional Perinatal Center; Emergency Hospital No. 2
Email: vladimirpog@rambler.ru
ORCID iD: 0000-0003-0010-7388
SPIN-code: 2675-5595
Pediatric Surgeon
Russian Federation, 2 Moskovsky trakt st., Tomsk, 634050; TomskDmitriy A. Balaganskiy
Siberian State Medical University; I.D. Evtushenko Regional Perinatal Center
Email: d_balaganskiy@mail.ru
ORCID iD: 0000-0003-0081-1025
SPIN-code: 5278-0243
Pediatric Surgeon
Russian Federation, 2 Moskovsky trakt st., Tomsk, 634050; TomskAnna B. Yushmanova
I.D. Evtushenko Regional Perinatal Center; Emergency Hospital No. 2
Email: annayushmanova@mail.ru
ORCID iD: 0000-0003-4413-9883
SPIN-code: 4806-6119
Pediatric Surgeon
Russian Federation, 2 Moskovsky trakt st., Tomsk, 634050; TomskViktor E. Gunther
Research Institute of Medical Materials and Implants with Shape Memory of Siberian physical-technical institute – Tomsk State Uuiversity
Email: hodor_val@mail.ru
ORCID iD: 0000-0002-6803-5934
SPIN-code: 9015-1666
Dr. Sci. (Tech.), Professor, Director of Institute
Russian Federation, 2 Moskovsky trakt st., Tomsk, 634050Valentina N. Khodorenko
Research Institute of Medical Materials and Implants with Shape Memory of Siberian physical-technical institute – Tomsk State Uuiversity
Email: hodor_val@mail.ru
ORCID iD: 0000-0002-5705-4072
SPIN-code: 3284-6574
Cand. Sci. (Phys.-Math.), Senior Researcher
Russian Federation, 2 Moskovsky trakt st., Tomsk, 634050Sergej G. Anikeev
Research Institute of Medical Materials and Implants with Shape Memory of Siberian physical-technical institute – Tomsk State Uuiversity
Email: anikeev_sergey@mail.ru
ORCID iD: 0000-0001-9323-5973
SPIN-code: 8054-6426
Cand. Sci. (Phys.-Math.), Senior Researcher
Russian Federation, 2 Moskovsky trakt st., Tomsk, 634050References
- Doroshevskii YuL, Nemilova TK. «T-obraznyi» anastomoz v lechenii ostroi kishechnoi neprokhodimosti u novorozhdennykh. Grekov’s bulletin of surgery. 1979;122(12):3–19. (In Russ.)
- Wit J, Sellin S, Degenhard P, et al. Is the Bishop – Koop anastomosis in treatment of neonatal ileus still current. Chirurg. 2000;71:307–10. doi: 10.1007/s001040051055
- Bell RH, Johnson FE, Lilly JR. Intestinal anastomoses in neonatal surgery. Ann Surg. 1976;183(3):276–281. doi: 10.1097/00000658-197603000-00011
- Zigan’shin RV, Gyunter VEh, Gibert BK. Kompressionnye anastomozy v zheludochno-kishechnoi khirurgii, vypolnennye pri pomoshchi ustroistva iz splava s pamyat’yu formy. Pirogov Russian journal of surgery. 1990;66(8):115–120. (In Russ.)
- Gyunter VEh, Dambaev GTs, Sysolyatin PG, Zigan’shin RV. Meditsinskie materialy i implantaty s pamyat’yu formy. Tomsk: Izd-vo Tomskogo un-ta, 1998. 487 P. (In Russ.)
- Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–213. doi: 10.1097/01.sla.0000133083.54934.ae
- Isakov YuF, Stepanov EhA, Vasil’ev GS. Magnitnо-kompressionnye anastomozy v khirurgii trubchatykh organov u detei. Sovetskaya pediatriya. 1987;(5):44–63. (In Russ.)
- Patent RUS № RU 2410039 C1/14.07.05.2009. Byul. № 3. Petlakh VI, Gatkin EYa, Sergeev AV, et al. Sposob formirovaniya magnitnogo mezhkishechnogo anastomoza. Available from: https://www.elibrary.ru/item.asp?id=37465840 (In Russ.)
- Bissaliyev BN, Tsap NA, Tussupkaliev AB, et al. Magnetic Compression Inter-Intestinal Anastomosis in the Treatment of Children with Enterostomes. Novosti Khirurgii. 2020;(1):46–52. (In Russ.) doi: 10.18484/2305-0047.2020.1.46.
- Aksel’rov MA. Pervyi opyt ispol’zovaniya kompressionnogo otsrochennogo anastomoza pri rezektsii kishki v usloviyakh peritonita u detei. Russian Journal of Pediatric Surgery. 2010;(4):51–52. (In Russ.)
- Popov FB, Nemilova TK, Karavaeva SA. Ehnterostomiya v neotlozhnoi abdominal’noi khirurgii novorozhdennykh. Russian Journal of Pediatric Surgery. 2004;(5):20–23. (In Russ.)
- Balaganskii DA, Karavaev AV, Osipkin VG, et al. Primenenie kompressionnykh ustroistv iz nikelida titana s pamyat’yu formy pri lechenii kishechnoi neprokhodimosti v detskom vozraste. Medicine in Kuzbass. 2007;(1):12–13. (In Russ.)
- Gassan TA, Stepanov EA, Krasovskaya TV, et al. A morphological substantiation of a tactic in closing the intestinal stomas formed during the neonatal period. Russian Journal of Pediatric Surgery. 2003;(6):11–13. (In Russ.)
- Bhat S, Cameron NR, Sharma P, et al. Chyme recycling in the management of small bowel double enterostomy in pediatric and neonatal populations: A systematic review. Clinical nutrition ESPEN. 2020;37:1–8. doi: 10.1016/j.clnesp.2020.03.013
- Aksel’rov MA, Emel’yanova VA, Sergienko TV. Khirurgicheskaya problema neonatal’nogo perioda — progressiruyushchii nekrotiziruyushchii ehnterokolit — i puti ee preodoleniya. Medical newsletter of Vyatka. 2015;(2):17–20. (In Russ.)
- Peng YF, Zheng HQ, Zhang H, et al. Comparison of outcomes following three surgical techniques for patients with severe jejunoileal atresia. Gastroenterology report. 2019;7(6):444–448. doi: 10.1093/gastro/goz026
- Martynov I, Raedecke J, Klima-Frysch J, et al. The outcome of Bishop – Koop procedure compared to divided stoma in neonates with meconium ileus, congenital intestinal atresia and necrotizing enterocolitis. Medicine. 2019;98(27):e16304. doi: 10.1097/MD.0000000000016304
- Haithem HAA. Meconium ileus a study and comparison between common operative procedures performed in basrah. Basrah Journal of Surgery. 2016;22(2):84–90. doi: 10.33762/bsurg.2016.116618
- Eeftinck Schattenkerk LD, Backes M, de Jonge WJ, et al. Treatment of Jejunoileal Atresia by primary anastomosis or Enterostomy: Double the operations, double the risk of complications. J Pediatr Surg. 2021;28:S0022-3468(21)00530-3. doi: 10.1016/j.jpedsurg.2021.07.021
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