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. 2024 Nov 23;16(11):e74296.
doi: 10.7759/cureus.74296. eCollection 2024 Nov.

Sutureless Loop Enterostomy in Very Low and Extremely Low Birth Weight Infants

Yuki Muta  1 , Akio Odaka  1 , Seiichiro Inoue  1 , Yuta Takeuchi  1
Affiliations

Sutureless Loop Enterostomy in Very Low and Extremely Low Birth Weight Infants

Yuki Muta et al. Cureus. .

Abstract

Introduction Sutureless enterostomy is used as an effective technique for constructing an enterostomy in very low and extremely low birth weight infants in Japan. Sutureless enterostomy is a separate type of enterostomy procedure for low birth weight infants. We adapted this technique and developed sutureless loop enterostomy (SLE), an approach without a skin bridge in which the intestinal wall is not sutured to the abdominal wall. This study aimed to compare SLE outcomes with those of sutureless enterostomy (SE) and the conventional procedure (C). Methods We retrospectively reviewed clinical records of 32 very low or extremely low birth weight infants who underwent enterostomy and classified the infants into three groups according to the procedure: SLE, SE, and C. We compared surgery-related items and enterostomy-related complications between the three groups. Results We found no significant differences in sex, age at surgery, or surgical blood loss. The operation time was significantly shorter in the SLE group than in the C group (P < 0.05). The number of postoperative complications was not significantly different in the SLE group compared with the other two groups. Conclusion Sutureless loop enterostomy is an effective, safe procedure for enterostomy in very low and extremely low birth weight infants.

Keywords: extremely low birth weight infants; focal intestinal perforation; meconium-related ileus; necrotizing enterocolitis; very low birth weight infants.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Research Ethics Committee of Saitama Medical Center, Saitama Medical University issued approval SMC2021-140. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Intraoperative photographs and surgical schemas of sutureless loop enterostomy
(A, C) After performing a detailed intraperitoneal examination, the vessel tape is passed through the mesentery just below the perforation of the small intestine. (B, D) The intestine is placed at the edge of the wound, and the peritoneum, muscular layer, and skin are closed. The vessel tape is attached to the skin with surgical tape.
Figure 2
Figure 2. The appearance of four cases immediately after stoma construction and at the time of closure surgery in patients who underwent stoma construction with sutureless loop enterostomy (SLE).
We present the pre- and post-operative conditions in four cases, case a to case d.
Figure 3
Figure 3. Appearance of enterostomy using the sutureless enterostomy (SE) procedure.
One formed at both ends of the surgical site (a) and one formed using a double-barrel technique at one end of the surgical site (b).
Figure 4
Figure 4. Box plot showing the patient characteristics and surgery-related items in the sutureless loop enterostomy, sutureless enterostomy, and conventional procedure groups.
The presence or absence of a significant difference between each pair of groups was examined. Bonferroni correction was used to adjust the P values for multiple comparisons between the three groups. P values were calculated with the Mann-Whitney U test. C: conventional enterostomy; SE: sutureless enterostomy; SLE: sutureless loop enterostomy.
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