Technical Innovation

Pediatric Surgery International

, Volume 23, Issue 7, pp 685-688

First online:

T-tube ileostomy for intestinal perforation in extremely low birth weight neonates

  • M. RyglAffiliated withDepartment of Pediatric Surgery, 2nd Faculty of Medicine and Teaching Hospital in Motol, Institute of Postgraduate Medicine, Charles University Email author 
  • , K. PychaAffiliated withDepartment of Pediatric Surgery, 2nd Faculty of Medicine and Teaching Hospital in Motol, Institute of Postgraduate Medicine, Charles University
  • , Z. StranakAffiliated withInstitute for the Care of Mother and Child
  • , R. SkabaAffiliated withDepartment of Pediatric Surgery, 2nd Faculty of Medicine and Teaching Hospital in Motol, Institute of Postgraduate Medicine, Charles University
  • , R. BrabecAffiliated withDepartment of Obstetric and Adult and Paediatric Gynecology, 2nd Faculty of Medicine and Teaching Hospital in Motol, Charles University
  • , V. CunatAffiliated withInstitute for the Care of Mother and Child
  • , J. SnajdaufAffiliated withDepartment of Pediatric Surgery, 2nd Faculty of Medicine and Teaching Hospital in Motol, Institute of Postgraduate Medicine, Charles University

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

To evaluate the results of use of T-tube ileostomy in selected cases of intestinal perforation in extremely low birth weight (ELBW) neonates. The records of 288 ELBW neonates treated at author’s institution, from 1998 to 2003 were retrospectively reviewed to identify neonates operated for intestinal perforation with T-tube placement. T-tube was inserted into the bowel through the site of perforation or proximally to the perforated gut via separate stab incision. T-tubes were used in five ELBW neonates (BW 600–900 g, gestational age 25–27 weeks) with intestinal perforation, in four of them at the time of primary surgery and in one neonate 8 days after primary anastomosis. All patients survived and there were no serious complications related to the T-tube insertion. Median duration of T-tube placement was 4 weeks (range 3–8 weeks), full enteral feeding after T-tube insertion was achieved in 4 weeks (range 1–6 weeks). All sites of T-tube insertion closed spontaneously. T-tube ileostomy is an effective and safe technique for treatment of selected cases of intestinal perforation in ELBW neonates. With respect to the hypoperistalsis of immature bowel, we recommend the use of T-tube in all cases of isolated intestinal perforation in ELWB neonates.

Keywords

Extremely low birth weight neonates Intestinal perforation Enterostomy closure T-tube ileostomy Necrotising enterocolitis