T-Tube ileostomy for meconium ileus: Four decades of experience

Background/Purpose: The T-tube ileostomy was first used at Texas Children's Hospital in 1959. The purpose of this study is to update the experience since the initial report of this technique in 1981. Methods: A database of 448 patients with cystic fibrosis (CF) seen in the authors' institu...

Full description

Saved in:

Bibliographic Details
Published in:	Journal of pediatric surgery Vol. 35; no. 2; pp. 349 - 352
Main Authors:	Mak, Grace Z., Harberg, Franklin J., Hiatt, Peter, Deaton, Angie, Calhoon, Rachael, Brandt, Mary L.
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-02-2000
Subjects:	Cystic Fibrosis - complications Humans Ileostomy - methods Infant, Newborn Intestinal Obstruction - etiology Intestinal Obstruction - surgery Meconium T-tube cystic fibrosis Meconium ileus ileostomy
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Background/Purpose: The T-tube ileostomy was first used at Texas Children's Hospital in 1959. The purpose of this study is to update the experience since the initial report of this technique in 1981. Methods: A database of 448 patients with cystic fibrosis (CF) seen in the authors' institution was used to identify 83 patients (18.5%) who presented with meconium ileus. The clinic and hospital charts of these patients were reviewed retrospectively to identify patients who had undergone placement of a T-tube ileostomy. Results: Surgery was performed in 60 of 83 patients for complications of meconium ileus or failure to evacuate the meconium after a contrast enema. Of these patients, 21 of 60 (35%) underwent placement of a T-tube ileostomy. An additional 8 patients were identified who underwent placement of a T-tube ileostomy but were not included in the CF database, for a total of 29 patients who have been treated with T-tube ileostomy since 1959 at Texas Children's Hospital. Five patients were excluded from analysis because of insufficient data or misdiagnosis. One of the 24 patients in the series died of complications of prematurity. A total of 20 of 23 patients had resolution of their meconium ileus after T-tube irrigation with n-acetylcysteine or pancreatic enzymes. Three patients required additional surgery to relieve persistent bowel obstruction. All patients had the T -tube removed within the first 8 weeks after surgery. Two patients required subsequent repair of an incisional hernia. There were otherwise no complications of this procedure, with an average follow-up of 11.5 years. Conclusion: In patients with uncomplicated meconium ileus unrelieved by contrast enema, the Ttube ileostomy is an effective and safe treatment.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0022-3468 1531-5037
DOI:	10.1016/S0022-3468(00)90038-1