Treating neonatal intestinal obstruction with ostomy in continuity: a single-center comparative study.

Abstract

Background: There is an array of surgical modalities available to treat neonatal intestinal obstruction, but there is no consensus on the optimal method. The study aims to evaluate the therapeutic efficacy of ostomy in continuity (OIC), providing a reference for surgeons to determine the appropriate surgical approach.

Methods: The study involved a retrospective analysis of the clinical data of 46 neonates with intestinal obstruction hospitalized between June 2019 and February 2024. The types of intestinal injuries included in the study comprised atresia, necrotizing enterocolitis (NEC), meconium ileus and volvulus. Based on their surgical procedures, patients were divided into the OIC group and the control group. General information, as well as perioperative and postoperative complications, were compared between the two groups.

Results: There were 18 patients underwent OIC, and 28 patients underwent double-barrel or single-barrel enterostomies. There were no statistically significant differences between patients in the two groups in terms of general information, duration of the ostomy surgery (P=0.66), bleeding volume (P=0.25), length of post-ostomy hospital stay (P=0.08), and time to first defecation after surgery (P=0.23). Compared to the control group, neonates in the OIC group had a shorter duration of parenteral nutrition (P=0.02), a shorter interval between stoma creation and closure surgeries (P=0.02), a shorter duration of stoma closure surgery (P<0.001), and fewer postoperative complications (P<0.001). The weight-for-age Z-score before the stoma closure surgery was better in the OIC group than the control group (P=0.01).

Conclusions: In this study, we found that OIC, as a treatment for neonatal intestinal obstruction, was effective in maintaining intestinal continuity, improving the nutritional status of neonates, and shortening the interval between the stoma creation and closure surgeries.