关键词: 关瘘术, 新生儿坏死性小肠结肠炎, 肠造瘘术

Abstract: Objective Most neonates with necrotizing enterocolitis （NEC） requiring bowel resection and enterostomy. But the optimal timing of ostomy closure is a matter of debate. The purpose of this study was to determine the ideal time for stoma closure in infants with necrotizing enterocolitis. Methods This study retrospectively analyzed the data of infants undergoing necrotic intestinal resection and enterostomy due to NEC from August 2010 to January 2019 in Shenzhen Children's Hospital Neonatal Surgery. For analysis, we define early closure （EC） as 8 weeks （including 8 weeks） after enterostomy, and late closure （LC） as 8 weeks after enterostomy. Results Of the 58 children, 35 were male and 23 were female. The surgical indication was 40 cases of pneumoperitoneum and 18 cases of infections that could not be controlled by conservative treatment, of which 27 cases were early closure （EC） and 31 cases were late closure （LC）. 18 patients in the EC group required ventilator support （66.67%）, while 10 patients in the LC group （32.26%） （P<0.05）. The EC group required longer bowels than the LC group External nutritional support; and the length of hospital stay in the EC group was much longer than that in the LC group. Thirteen patients underwent reoperation for adhesion intestinal obstruction （of which 7 cases, LC group 6 cases）. In the EC group, 4 patients had poor postoperative incision healing, 2 patients died of sepsis, and 1 patients died of short bowel syndrome and severe malnutrition. All patients in the LC group recovered well after surgery and all survived. Conclusion This study suggests that the late stoma closure after NEC enterostomy is significantly better than the early closure.

Key words: stoma closure, necrotizing enterocolitis, enterostomy