Chen Faling,Xu Weijue,Huang Xiong,et al.Experience of treatment of intestinal stenosis after one-stage intestinal resectional anastomosis for neonatal necrotizing enterocolitis[J].Journal of Clinical Pediatric Surgery,,19():1016-1020.[doi:10.3969/j.issn.1671-6353.2020.11.011]
Experience of treatment of intestinal stenosis after one-stage intestinal resectional anastomosis for neonatal necrotizing enterocolitis
- Keywords:
- Enterocolitis; Necrotizing; Gastroenterostomy; Infant; Newborn
- CLC:
- R722.1;R574.62
- Abstract:
- Objective To summarize the treatment of intestinal stenosis after one-stage intestinal resectional anastomosis for neonatal necrotizing enterocolitis (NEC).Methods Clinical data were retrospectively reviewed for 18 NEC children with stenosis after one-stage intestinal resectional anastomosis from June 2012 to June 2019.The relevant data included time from a diagnosis of NEC to intestinal stenosis,operative age,location of stenosis and postoperative complications.Results The average time from a diagnosis of NEC to intestinal stenosis was 45.7 days and the average operative age 73.8 days.The locations were terminal ileum (n=7),ascending colon (n=5) and descending colon (n=2).And multiple stenoses were found at ileocecal & hypoglycemic junctions (n=1),terminal ileum & hypoglycemic junction (n=1),ascending & middle transverse colons (n=1) and colonic hepatic & spleen curvatures (n=1).The causes of complications were anastomotic leak (n=3),anastomotic stenosis (n=1) and anastomotic proximal intestinal adhesion (n=1).And 4/5 complicated cases underwent intestinal re-ostomy.Three cases of intestinal ostomy achieved closure and had no other complications.During follow-ups,the prognosis was decent.Conclusion One-stage intestinal resectional anastomosis is generally effective for intestinal stenosis after NEC.Stenosis occurs frequently in terminal ileum and ascending colon.A definite diagnosis is based upon clinical manifestations and gastrointestinal angiography.Suspicious bowel is filled with water intraoperatively for excluding multiple stenoses.NEC has a certain onset time for intestinal stenosis.It is necessary to grasp the timing of one-stage surgery and ensure the quality of remaining intestinal tract to avoid postoperative recurrence of stenosis.
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Memo
收稿日期:2019-11-20。
基金项目:上海市浦江人才计划资助（编号：19PJ1409000）；上海市儿童医院临床研究培育专项重点项目（编号：2019YLYZ03）
通讯作者:徐伟珏,Email:fafa84074138@126.com