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Historical development of T-tube enterostomy

Petar Stamov



The word stoma comes from the Greek stomoun (making an opening or mouth). The term ostomy in childhood includes any surgically created opening between a hollow organ (e.g., stomach, small or large intestine) and the skin, connected directly (stoma) or by means of a tube. Creating an intestinal stoma in childhood is considered a drastic procedure and has long been avoided due to the high incidence of complications and mortality. Despite the successful application of enterostomy methods of the large intestine and later—of the small intestine, in children, this technique has developed relatively slowly. Stoma removal techniques, originally developed for adults, have been modified and adapted for pediatric patients.


Information from the worldwide database on the historical development of T-tube enterostomy was selected and analyzed. A systematic literature search was performed using PubMed, MEDLINE, EMBASE, the Cochrane database, and Scopus, using the following terms: T- tube, enterostomy, pediatric, childhood.


In February 1981, the treatment of uncomplicated meconium ileus in neonates by means of a T-tube enterostomy was first reported by Harberg et al. T-tube ileostomy was first used at Texas Children’s Hospital in 1959. In their first report, the authors reported on 11 newborns with uncomplicated meconium ileus who underwent a T-tube ileostomy within 24 to 96 hours after birth. Of 7 girls and 4 boys, only two were unable to overcome the ileus. One infant required re-examination for persistent obstruction, and 1 infant died due to pulmonary infection and intracranial hemorrhage. The remaining 9 infants overcame the ileus between the 1st and 11th days. The T-tube was removed by pulling it between days 10 and 14 after the spontaneous closing of the T-tube fistula in all patients. Experience with T-tube ileostomy has shown that resection of the dilated but viable ileum is not necessary for rapid recovery of intestinal function in the newborn. With the use of intraluminal administration of pancreatic enzyme, stringy meconium can be rapidly lysed and passed through the rectum or T-tube, and mechanical removal is not required during the operative procedure.


Using a T-tube has several advantages. One of them is the smaller surgical intervention and minimal intra-abdominal bowel manipulation. Spontaneous closure of the fistula occurs rapidly after T-tube removal. This technique shows less morbidity and mortality than conventional ostomy.


T-tube, enterostomy, pediatric, newborn

Full Text


Cataldo PA. History of stomas. In: MacKeigan JM, Cataldo PA, editors. Intestinal Stomas: Principles, Techniques, and Management. St. Louis, MO: Quality Medical Publishers; 1993. p. 3–37.

Scharli WF. The history of colostomy in childhood. Prog Pediatr Surg. 1986;20:188–98. doi: 10.1007/978-3-642-70825-1_14.

Brooke BN. Historical perspectives. In: Dozois RR, editor. Alternatives to Conventional Ileostomy. Chicago:Year Book Medical; 1985. pp. 19–28.

Bishop HC, Koop CE. Management of meconium ileus: resection, Roux-en-Yanastomosis and ileostomy irrigation with pancreatic enzymes. Ann Surg. 1957;145(3):410–4. doi: 10.1097/00000658-195703000-00017.

Nixon HH. Colostomy: a simple technique, and observations on indications. Z Kinderchir. 1966;3:98–103.

Randolph JG,Zollinger Jr RM, Gross RE. Mikulicz resection in infants and children: a 20-year survey of 196 patients. Ann Surg. 1963;158(3):481–5. doi: 10.1097/00000658-196309000-00015.

Santulli TV, Blanc WA. Congenital atresia of the intestine, pathogenesis and treatment. Ann Surg. 1961;154(6):939–48.

Coln D. Simultaneous drainage gastrostomy and feeding jejunostomy in the newborn. Surg Gynecol Obstet. 1977;145(4):594–5.

Gauderer MWL. Double-tube enterostomy for temporary small bowel decompression. Pediatr Surg Int. 1986;1:60–2.

Rehbein F, Halsband M. A double-tube technique for the treatment of meconium ileus and small bowel atresia. J Pediatr Surg. 1968;3:723–6.

Andrassy RJ, Page CP, Feldman RW, Haff RC, Ryan JA Jr, Ratner IA. Continual catheter administration of an elemental diet in infants and children. Surg. 1977;82(2):205–10.

Driver CP, Barrow C, Fishwick J, Gough DC, Bianchi A, Dickson AP. The Malone antegrade colonic enema procedure: outcome and lessons of six years' experience. Pediatr Surg Int. 1998;13(5-6):370–2. doi: 10.1007/s003830050342

Fitzgerald PG, Lau GY, Cameron GJ. Use of the umbilical site fortemporary ostomy: review of 47 cases. J Pediatr Surg. 1989;24(10):973. doi: 10.1016/s0022-3468(89)80194-0.

Gauderer MW, Boyle JT. Cholecystoappendicostomy in a child with Alagille syndrome. J Pediatr Surg. 1997;32(2):166-7. doi: 10.1016/s0022-3468(97)90172-x.

Harberg FJ, Senekjian EK, Pokorny WJ. Treatment of uncomplicated meconium ileus via T-tube ileostomy. J Pediatr Surg. 1981;16(1):61–3. doi: 10.1016/s0022-3468(81)80117-0.

Mitrofanoff P. Cystostomie continente trans-appendiculaire dans le traitement des vessies neurologiques [Trans-appendicular continent cystostomy in the management of the neurogenic bladder]. Chir Pediatr. 1980;21(4):297-305. French.

Schimpl G, Mayr J, Gauderer MWL. Jejunostomy with replaceable feeding tube: a new technique. J Am Coll Surg. 1997;184(6):652–4.

Shandling B, Chait PG, Richards HF. Percutaneous cecostomy: a new technique in the management of fecal incontinence. J Pediatr Surg 1996;31(4):534–7. doi: 10.1016/s0022-3468(96)90490-x.

Stellato TA, Gauderer MWL. Jejunostomy button as a new method for long-term jejunostomy feedings. Surg Gynecol Obstet. 1989;168(6):552–4.

Haut ER, Nance ML, Keller MS. Management of penetrating colon and rectal injuries in the pediatric patient. Dis Colon Rectum. 2004;47(9):1526-32. doi: 10.1007/s10350-004-0605-0.

Bron PA, Kleerebezem M, Brummer RJ, Cani PD, Mercenier A, MacDonald TT, et al. Can probiotics modulate human disease by affecting intestinal barrier function? Bro J Nutr. 2017;117(1):93-107. doi: 10.1017/S0007114516004037.

De Carli C, Ojeda M, Veloce D, González M. T-tube enterostomy for the management of complicated high jejunal atresia. An innovative procedure for complex intestinal entity. A technical report. J Pediatr Surg Case Rep. 2016;7:39-42. doi: 10.1016/j.epsc.2016.02.016.

Freeman C, Delegate MH. Small bowel endoscopic enteral access. Curr Opin Gastroenterol. 2009;25(2):155–9. doi: 10.1097/MOG.0b013e328324f86b.

Koga H, Yamataka A, Yoshida R, Unemoto K. Laparoscopic-assisted repair for prolapsed colostomy in an infant. Pediatr Endosurg Innov Tech. 2004;8(3):275–8. doi:10.1089/pei.2004.8.275.

Miyano G, Yanai T, Okazaki T, Kobayashi H, Lane G, Yamataka A. Laparoscopy-assisted stoma closure. J Laparoendosc Adv Surg Tech A. 2007;17(3):395-8. doi: 10.1089/lap.2006.0074.

Nagle AP, Murayama KM. Laparoscopic gastrostomy and jejunostomy. J Long Term Eff Med Implants 2004;14:1–11.

Raval MV, Phillips JD. Optimal enteral feeding in children with gastric dysfunction: surgical jejunostomy vs image-guided gastro-jejunal tube placement. J Pediatr Surg 2006;41(10):1679–82. doi: 10.1016/j.jpedsurg.2006.05.050.

Rawat DJ, Haddad M, Geoghegan N, Clarke S, Fell JM. Percutaneous endoscopic colostomy of the left colon: a new technique for management of intractable constipation in children. Gastrointest Endosc. 2004;60(1):39-43. doi: 10.1016/s0016-5107(04)01286-6.

Davies A. Children with ostomies: parents helping parents. J ET Nurs. 1992;19(6):207–12.

Bray L, Sanders C. Preparing children and young people for stoma surgery. Paediatr Nurs. 2006;18(4):33–7. doi: 10.7748/paed2006.

Dylag K, Hubalewska-Mazgaj M, Surmiak M, Szmyd J, Brzozowski T. Probiotics in the mechanism of protection against gut inflammation and therapy of gastrointestinal disorders. Curr Pharm Des. 2014;20(7):1149-55. doi: 10.2174/13816128113199990422.

Hampton BG, Bryant RA. Ostomies and continent diversions. St. Louis, MO: Mosby-Year Book; 1992.

Kirkland S. Ostomy dolls for pediatric patients. J Enterostomal Ther. 1985;12(3):104–5. doi: 10.1097/00152192-198505000-00040.

Mullen BD, McGinn KA. The ostomy book: living comfortably with colostomies, ileostomies, and urostomies. Palo Alto, CA: Bull Publishing; 1992.

Versalovic J. The human microbiome and probiotics: implications for pediatrics. Ann Nutr Metab. 2013;63 Suppl 2:42-52. doi: 10.1159/000354899.

Wilkins T, Sequoia J. Probiotics for gastrointestinal conditions: a summary of the evidence. Am Fam Physician. 2017;96(3):170-8.

Teitelbaum DH, Cilley RE, Sherman NJ, Bliss D, Uitvlugt ND, Renaud EJ, et al. A decade of experience with the primary pull-through for hirschsprung disease in the newborn period: a multicenter analysis of outcomes. Ann Surg. 2000;232(3):372-80. doi: 10.1097/00000658-200009000-00009.

Millar AJ, Lakhoo K, Rode H, Ferreira MW, Brown RA, Cywes S. Bowel stomas in infants and children. A 5-year audit of 203 patients. S Afr J Surg. 1993;31(3):110-3. PMID: 8128323.

Millar AJ, Rode H, Cywes S. Management of uncomplicated meconium ileus with T tube ileostomy. Arch Dis Child. 1988 Mar;63(3):309-10. doi: 10.1136/adc.63.3.309-a.

Mak GZ, Harberg FJ, Hiatt P, Deaton A, Calhoon R, Brandt ML. T-tube ileostomy for meconium ileus: four decades of experience. J Pediatr Surg. 2000;35(2):349-52. doi: 10.1016/s0022-3468(00)90038-1.

Al-Zaiem M, Al-Garni AF, Al-Maghrebi A, Asghar AA. Use of T-tube enterostomy in neonatal gastro-intestinal surgery. J Neonatal Surg. 2016;5(4):46. doi: 10.21699/jns.v5i4.456.

Rygl M, Pycha K, Stranak Z, Skaba R, Brabec R, Cunat V, et al. T-tube ileostomy for intestinal perforation in extremely low birth weight neonates. Pediatr Surg Int. 2007;23(7):685–8. doi: 10.1007/s00383-007-1931-9.

Pandey A, Kumar V, Gangopadhyay AN, Upadhyaya VD, Srivastava A, Singh RB. A pilot study on the role of T-tube in typhoid ileal perforation in children. World J Surg 2008;32(12):2607–11. doi: 10.1007/s00268-008-9746-y.

Blaszczynski M, Porzucek W, Becela P, Gadzinowski J. T-tube enterostomy in surgical management of emergency cases in neonates. Arch Perinat Med. 2011;17(2):93-6.

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About The Author

Petar Stamov
Medical university of Varna

Department of General and Operative Surgery, Faculty of Medicine

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