OBJECTIVE
The aim of this study is to describe the technique of enterostomy closure in children using laparoscopy.
MATERIALS AND METHODS
In 20 newborns who were in the Ivano-Matreninskaya Children’s Clinical Hospital over the past 5 years, since 2015, was performed laparoscopically-assisted closure of enterostomy. Their age ranged from 36 to 160 days, and their body weight ranged from 2 to 4.1 kg. The surgery was performed under general anesthesia. The optical trocar was inserted through the umbilicus using an open method. Laparoscopy was used to examine the bowel, enterostomy, and adhesion separation. The search and mobilization from the peritoneal adhesions of the abducent segment of the intestine, tied with a colored ligature during bowel resection during the first operation, was performed. Next, a slightly enlarged skin incision was made around the circumference of the enterostomy and its release from the tissues of the abdominal wall was performed. The distal segment of the intestine was then removed into this incision in order to perform a two-row extracorporeal intestinal anastomosis. Further, the segment of the intestine with the anastomosis was dropped into abdominal cavity. The wound of the abdominal wall was closed.
RESULTS
All patients were successfully operated without intraoperative complications and conversions to open surgery. The average duration of surgery, including the laparoscopic and open stages, was 59.5 minutes. The start of enteral feeding was carried out at an average of 3 days. The length of hospital stay was 9.1 days on average. In the early postoperative period, 1 case of wound infection was recorded. In the long-term follow-up period, on average, over 12 months, there was 1 case of small bowel obstruction, which required repeated laparoscopy and dissection of adhesions located distal to the anastomosis.
CONCLUSION
The experience of laparoscopically-assisted enterostomy closure in young children, demonstrated in this study, demonstrates the safety and effectiveness of this approach.
