Application of santulli procedure enterostomy in treatment of high unformed small bowel fistula in children

Abstract

Objective To explore the role of Santulli procedure enterostomy in treatment of high unformed small bowel fistula in children. Methods From May 2007 to Oct.2011, 6 cases suffered with high unformed small bowel fistula were treated with Santulli procedure enterostomy.Five male and 1 female were involved and their ages were ranged from 15 days to 5 years. Results The mean time from final diagnosis of intestinal fistula to the definite operation was (52.33±19.03) h, the distance between fistula to the ligament of Treize was (17.33±4.68)cm, the output of enterostomy was (760.00±107.56) mL/d.In the surgical explore, 6 cases suffered intestinal adhesions but none of the cases could be separated, 5 cases suffered severe and 1 case with moderate intra-abdominal pollution.The preoperative complications included 6 cases with incision infection, 1 case with a fully dehiscence of incision, 6 cases with gene-ralized peritonitis, 2 cases with impaired renal function, 1 case with liver dysfunction, 3 cases with systemic inflammatory reaction syndrome and sepsis respectively, 1 case of incision infection appeared in post-operation.The pediatric critical illness scores and serum albumin of postoperative 3 days and 7 days were higher than those of preoperative(all P<0.05). None of the cases suffered the anastomotic leak.The nutrition and growth were normal during the follow-up period of 8 months to 2 years. Conclusions Santulli procedure enterostomy is suitable in treatment of high unformed small bowel fistula in children, and the early performance will improve prognosis. Key words: Intestinal fistula; Small intestine; Enterostomy; Child