Differentiated approach to intestinal stoma formation in infants with necrotizing enterocolitis and gastrointestinal tract malformation, intestinal stoma complications.

Abstract

Modern methods of early prenatal and postnatal diagnosis of malformations and acquired acute inflammatory diseases of the gastrointestinal tract of newborns make it possible to perform timely early surgical correction. However, to date, remain relevant and controversial issues of palliative surgical interventions in landmark surgical correction bowel disease. This is due to the fact that the implementation of radical correction of newborns with congenital or acquired intestinal development of acute surgical diseases of the intestine without the formation of a stoma increases the risk of undesirable serious complications. Therefore, a significant group of patients in need of staged surgical treatment with the initial formation of an intestinal stoma. To date, there is also no unified management of patients with surgical stage of neonatal necrotizing enterocolitis. Among the options of surgical care to patients with perforated NEC have supporters’ resection with primary anastomosis and supporters with the phased withdrawal of treatment with intestinal stoma followed by reconstructive surgery. Even at the present stage of development of surgical care to the formation of intestinal stomas may be accompanied by tactical, technical errors, and improper care of ostomy leads to the development of local or systemic complications, significantly impair a patient's quality of life, lead to an increase in time and cost of treatment of the underlying disease. Currently there is no common standard and indications for the overlay of intestinal stoma, the level of its formation, the duration of existence, and the existing number of possible causes complications to choose an individual approach in the treatment of this patient group.