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Observational Study
. 2019 Jul;98(27):e16304.
doi: 10.1097/MD.0000000000016304.

The outcome of Bishop-Koop procedure compared to divided stoma in neonates with meconium ileus, congenital intestinal atresia and necrotizing enterocolitis

Illya Martynov  1   2 , Jochen Raedecke  2 , Jessica Klima-Frysch  2 , Wolfram Kluwe  2 , Joachim Schoenberger  2
Affiliations
Observational Study

The outcome of Bishop-Koop procedure compared to divided stoma in neonates with meconium ileus, congenital intestinal atresia and necrotizing enterocolitis

Illya Martynov et al. Medicine (Baltimore). 2019 Jul.

Abstract

To determine the potential value and suitability of Bishop-Koop procedure (BK) compared to divided stoma (DS) in neonates with meconium ileus (MI), congenital intestinal atresia (CIA), and necrotizing enterocolitis (NEC).A retrospective data collection from 2000 to 2019 on neonates undergoing BK and DS formation and closure for MI, CIA, and NEC was conducted. Ostomy related complications following both procedures were analyzed.One hundred two consecutive patients managed with a BK (n = 57, 55.8%) and DS (n = 45, 44.2%) for MI (n = 38, 37.2%), CIA (n = 31, 30.5%), and NEC (n = 33, 32.3%) were analyzed. Mean operating time for ostomy creation did not differ significantly between BK and DS groups (156 ± 54 vs 135 ± 66.8 min, P = .08). The prevalence of stoma-related complications following BK and DS formation was 8.7% and 31.1%, respectively (P = .005). The complication rate after BK and DS closure was 3.5% and 6.7%, respectively (P = .65). The operating time for ostomy reversal and length of hospital stay after stoma closure were significantly shorter in BK group (82.2 ± 51.4 vs 183 ± 84.5 min and 5.5 ± 2.7 vs 11.3 ± 3.9 days, P < .001).BK procedure is safe, reliable, and suitable technique in neonatal surgery with low complications rate following ostomy creation as well as shorter operating time and length of hospital stay after ostomy closure compared to DS ostomies. Surgeons should keep this technique as an alternative approach in their repertoire.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Intraoperative photograph of patient with atresia of the terminal ileum and non-used microcolon (not shown) shows primary anastomosis (asterisk) and protective Bishop-Koop enterostomy following resection of the atretic bowel segment. The end of the proximal intestine (white arrow) is anastomosed to the side of the distal intestine. “Chimney” segment (black arrow) will be exteriorized through a small incision.
Figure 2
Figure 2
Means and standard deviations of the operating times for ostomy closure for BK and DS. BK = Bishop-Koop procedure, DS = divided stoma.
Figure 3
Figure 3
Means and standard deviations of the length of hospital stay after ostomy closure for BK and DS. BK = Bishop-Koop procedure, DS = divided stoma.
See this image and copyright information in PMC

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