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Sutured Versus Sutureless Enterostomies: An Alternative Technique in Critically Sick Neonates

Background and objective Intestinal perforations and necrotizing enterocolitis (NEC) requiring the formation of temporary intestinal stoma are prevalent conditions worldwide. This prospective study aimed to address the following research question: does sutureless enterostomy lead to fewer complicati...

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Autores principales: Ahmed, Ezza, Talat, Nabila, Adnan, Hafiz M, Butt, Jamal, Star, Farrakh Mahmood, Manzoor, Anum
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9096737/
https://www.ncbi.nlm.nih.gov/pubmed/35573560
http://dx.doi.org/10.7759/cureus.24057
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author Ahmed, Ezza
Talat, Nabila
Adnan, Hafiz M
Butt, Jamal
Star, Farrakh Mahmood
Manzoor, Anum
author_facet Ahmed, Ezza
Talat, Nabila
Adnan, Hafiz M
Butt, Jamal
Star, Farrakh Mahmood
Manzoor, Anum
author_sort Ahmed, Ezza
collection PubMed
description Background and objective Intestinal perforations and necrotizing enterocolitis (NEC) requiring the formation of temporary intestinal stoma are prevalent conditions worldwide. This prospective study aimed to address the following research question: does sutureless enterostomy lead to fewer complications compared to conventional enterostomy in critically sick surgical neonates who need a stoma? Methods We conducted a randomized control trial (TCTR20211011004) from October 2020 to October 2021. A total of 120 patients were randomized to the following two study groups: Group A: conventional sutured enterostomy; Group B: sutureless enterostomy, with 60 patients in each group. The operative time, complications, and mortality were compared between the two groups using the chi-squared test. Results The groups were comparable with respect to the mean age at presentation, gestational age, weight, and sex ratio. In Group A, the main operative diagnoses were NEC in 22 patients, pneumoperitoneum in 25, complicated meconium ileus in nine, bowel atresia in three, and midgut volvulus in one; while in Group B, 25 patients had NEC, 20 had pneumoperitoneum, eight had meconium ileus, two had bowel atresia, and five had midgut volvulus. The mean operative time (93.5 ± 28.71 minutes) was significantly longer in the conventional group compared to the sutureless group (52.08 ± 18.53 minutes). Oral feed was started significantly earlier in the sutureless stoma group. Mortality was 43.3% in Group A and 46.6% in Group B. Complication rate was significantly higher in sutured stoma group. Conclusion The management of critically sick neonates, especially those with NEC and intestinal perforation, still presents a surgical dilemma. Based on our findings, the sutureless enterostomy may reduce operative time and complications in critically sick neonates.
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spelling pubmed-90967372022-05-14 Sutured Versus Sutureless Enterostomies: An Alternative Technique in Critically Sick Neonates Ahmed, Ezza Talat, Nabila Adnan, Hafiz M Butt, Jamal Star, Farrakh Mahmood Manzoor, Anum Cureus Pediatric Surgery Background and objective Intestinal perforations and necrotizing enterocolitis (NEC) requiring the formation of temporary intestinal stoma are prevalent conditions worldwide. This prospective study aimed to address the following research question: does sutureless enterostomy lead to fewer complications compared to conventional enterostomy in critically sick surgical neonates who need a stoma? Methods We conducted a randomized control trial (TCTR20211011004) from October 2020 to October 2021. A total of 120 patients were randomized to the following two study groups: Group A: conventional sutured enterostomy; Group B: sutureless enterostomy, with 60 patients in each group. The operative time, complications, and mortality were compared between the two groups using the chi-squared test. Results The groups were comparable with respect to the mean age at presentation, gestational age, weight, and sex ratio. In Group A, the main operative diagnoses were NEC in 22 patients, pneumoperitoneum in 25, complicated meconium ileus in nine, bowel atresia in three, and midgut volvulus in one; while in Group B, 25 patients had NEC, 20 had pneumoperitoneum, eight had meconium ileus, two had bowel atresia, and five had midgut volvulus. The mean operative time (93.5 ± 28.71 minutes) was significantly longer in the conventional group compared to the sutureless group (52.08 ± 18.53 minutes). Oral feed was started significantly earlier in the sutureless stoma group. Mortality was 43.3% in Group A and 46.6% in Group B. Complication rate was significantly higher in sutured stoma group. Conclusion The management of critically sick neonates, especially those with NEC and intestinal perforation, still presents a surgical dilemma. Based on our findings, the sutureless enterostomy may reduce operative time and complications in critically sick neonates. Cureus 2022-04-12 /pmc/articles/PMC9096737/ /pubmed/35573560 http://dx.doi.org/10.7759/cureus.24057 Text en Copyright © 2022, Ahmed et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Pediatric Surgery
Ahmed, Ezza
Talat, Nabila
Adnan, Hafiz M
Butt, Jamal
Star, Farrakh Mahmood
Manzoor, Anum
Sutured Versus Sutureless Enterostomies: An Alternative Technique in Critically Sick Neonates
title Sutured Versus Sutureless Enterostomies: An Alternative Technique in Critically Sick Neonates
title_full Sutured Versus Sutureless Enterostomies: An Alternative Technique in Critically Sick Neonates
title_fullStr Sutured Versus Sutureless Enterostomies: An Alternative Technique in Critically Sick Neonates
title_full_unstemmed Sutured Versus Sutureless Enterostomies: An Alternative Technique in Critically Sick Neonates
title_short Sutured Versus Sutureless Enterostomies: An Alternative Technique in Critically Sick Neonates
title_sort sutured versus sutureless enterostomies: an alternative technique in critically sick neonates
topic Pediatric Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9096737/
https://www.ncbi.nlm.nih.gov/pubmed/35573560
http://dx.doi.org/10.7759/cureus.24057
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