Chen Sheng,Yan Zhilong,Mei Dongyu,et al.Surgical treatments for verylowbirthweight infants with dynamic intestinal obstruction.[J].Journal of Clinical Pediatric Surgery,,17():349-353.
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Surgical treatments for verylowbirthweight infants with dynamic intestinal obstruction.

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: 第17卷 Number: 2018 05 Page: 349-353 Column: 论著 Date of publication: 2018-05-28
Author(s):
Chen Sheng; Yan Zhilong; Mei Dongyu; Xie Zhoulonglong; Chen Qimin.
Department of General Surgery,Shanghai Childrens Medical Center,School of Medicine,Shanghai Jiao Tong University,Shanghai,200127,China
Keywords:
Infant;  Verylowbirthweight infants;  Intestinal Obstruction;  Surgical Procedures; Operative;  Therapy
Document code:
A
Abstract:
ObjectiveTo explore the surgical indications and treatment strategies for verylowbirthweight (VLBW) infants with dynamic intestinal obstruction.MethodsRetrospective reviews were conducted for the clinical data of 10 VLBW infants with dynamic intestinal obstruction between January 2007 and December 2017.Since standard medical treatment (17 to 36 days) was ineffective,they were all operated.No intestinal malformations were found during laparotomy.Then ileostomy plus intestinal biopsy were performed.A secondary surgery was performed for closing stoma when these infants weighed over 5 kg.Another 10 VLBW infants with insufficient intestinal motility and feeding intolerance responding to conservative treatment were used as control group.Several severity indicators of intestinal motility disorders (e.g.frequencies of vomiting,stomach retention,temporary fasting or temporary reduction of milk) were compared between two groups.ResultsIntestinal motility disorders were more severe in surgical group than those in control group.Standard medical treatments were ineffective and there were 9 survivors and 1 death in surgical group.The survivors showed excellent growth and development.After a secondary surgery,there were normal defecation (n=7) and mild constipation (n=2).Pathological findings of twostage surgeries hinted at gradual maturation of gut ganglion cells.ConclusionFor VLBW infants with dynamic intestinal obstruction,ileostomy should be performed at terminal ileum when standard 3week medical treatment is ineffective.A secondary surgery should be performed for closing stoma when weights exceeded 5 kg.A complete evaluation of patency of distal bowel and development of gut ganglion cells is recommended before a secondary surgery for closing stoma.
Last Update: 2018-05-23