A comparative study between Santulli ileostomy and loop ileostomy in neonates with meconium ileus

ABSTRACT Background: Meconium ileus is a common cause of intestinal obstruction in neonates that different surgical methods have been described for its management such as Santulli and loop ileostomy. Aim: To evaluate and compare clinical efficacy of Santulli and loop ileostomy in neonates with meconium ileus. Methods: In this retrospective study, 58 patients with meconium ileus were evaluated. After analyses of hospital records, 53 patients with completed hospital records were included. Demographic information, surgery parameters and postoperative complications were extracted from the hospital records or calling parents. Results: Skin excoriation (21.4% vs. 84%, p<0.001), ostomy prolapsed (0 vs. 28%, p=0.003), and surgical site infection (7.1% vs. 28%, p=0.044) was significantly lower in Santulli ileostomy group. Furthermore, ileostomy output in first week (70.53±15.11 ml vs. 144.6±19.99 ml, p<0.001) and in 4th week (2.14±4.98 ml vs. 18.4±17.95 ml, p<0.001) was significantly lower in Santulli ileostomy group as compared to loop ileostomy group. Finally, hospital stay in Santulli ileostomy group was 12±2.34 and in loop ileostomy 14.24±1.47 days (p<0.001). Conclusion: Santulli ileostomy is better than loop ileostomy due to significant less frequency of surgical site infection, skin excoriation, prolapse of ostomy, ileostomy volume output and hospitalization time.

摘要
背景：胎粪性肠梗阻（Meconium ileus）是引发新生儿肠梗阻的常见病因，目前已有多种手术方式用于该病的治疗，例如桑图利回肠造口术（Santulli ileostomy）与袢式回肠造口术（loop ileostomy）。
研究目的：评估并比较桑图利回肠造口术与袢式回肠造口术治疗新生儿胎粪性肠梗阻的临床疗效。
方法：本研究为回顾性研究，共纳入58例胎粪性肠梗阻患者。经住院病历分析后，最终纳入53例病历完整的患者。从住院病历或致电患儿家属处提取其人口统计学资料、手术参数及术后并发症情况。
结果：桑图利回肠造口术组的造口周围皮肤剥脱发生率（21.4% vs. 84%，p<0.001）、造口脱垂发生率（0 vs. 28%，p=0.003）及手术部位感染发生率（7.1% vs. 28%，p=0.044）均显著低于袢式回肠造口术组。此外，相较于袢式回肠造口术组，桑图利回肠造口术组的术后第一周回肠造口引流量（70.53±15.11 ml vs. 144.6±19.99 ml，p<0.001）与术后第四周回肠造口引流量（2.14±4.98 ml vs. 18.4±17.95 ml，p<0.001）均显著更低。最后，桑图利回肠造口术组的住院时长为12±2.34天，袢式回肠造口术组为14.24±1.47天（p<0.001）。
结论：桑图利回肠造口术优于袢式回肠造口术，其手术部位感染、造口周围皮肤剥脱、造口脱垂、回肠造口引流量及住院时长均显著更低。