INTRODUCTION
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.
MATERIALS AND METHODS
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.
RESULTS AND DISCUSSION
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.
CONCLUSION
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.
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