Enterostomy in the complex of surgical treatment of newborn with diseases and malformations of the intestine

Abstract

Material and methods. An analysis of the treatment outcomes in 14 ostomy newborns with diseases and malformations of the intestine forms the basis of the paper.
Results. Long-term defunctionalisation of the distal segments of intestine leads to their hypotrophy and deep suppression of motor functions resulting in retention of intestinal contents at the level of anastomosis with the risk of suture failure. A new method of preparing the defunctioned bowel and objectification its readiness for reconstructive surgery is proposed. The method provides that in postoperative period the intestinal contents from the proximal segment of the intestine are collected from a child with a loop (double-barrelled) enterostomy. Intestinal contents are inserted into the distal segment through the stoma using a syringe and a probe in portions. The initial volume of intestinal contents, introduced through the stoma, is 1-2 ml, with a gradual its increase to the total volume obtained from the proximal segment of the intestine. Simultaneously retrograde hydrotraining of the defunctioned intestine is carried out with the help of cleansing enemas. Readiness of the defunctioned bowel is evaluated by the natural emergence of faeces after clearing enemas or spontaneous without it.
Conclusions. The use of the suggested method in the preoperative management of ostomy children allows preparing the defunctioned intestine and assesses its readiness for a reconstructive operation taking into account other criteria.