Emergency neonatal intestinal problems, such as necrotizing enterocolitis (NEC), spontaneous intestinal perforation (SIP), intestinal atresia, meconium cyst and meconium ileus, pose serious challenges for pediatric surgeons and neonatologists. Stoma creation and primary anastomosis have been used for decades with various advantages and disadvantages of each approach.1–4 Stoma creation is usually required in cases with generalized peritonitis and when perfusion and viability of distal parts of the intestine are questionable during laparotomy. In these life-threatening situations stoma formation results in improvement of survival.5 The main disadvantage of intestinal exteriorization is the need of another procedure for closure with prolonged hospitalization and repeated admissions. Other disadvantages include stoma-associated complications, such as high-output losses, electrolyte derangements, stenosis, skin excoriation, prolapse or retraction of the stoma, and parastomal protrusion or internal herniation through a mesenteric defect.1–4 Primary anastomosis should be performed in a neonate who is stable and has localized bowel disease.6 7 Potential problems with primary anastomosis are anastomotic leak, peritonitis, anastomotic stricture, stasis, and bacterial overgrowth. These are the main reasons why primary anastomosis is not often attempted in extremely low birthweight (ELBW) newborns.8 ‘T-tube’ enterostomy is an alternative technique for a variety of such emergent intestinal problems.9–11 ‘T-tube’ combines the advantages of enterostomy (intestinal decompression, functioning low-output stoma) with those of primary anastomosis (restoration of intestinal continuity, preventing the need for a second operation, and avoiding stoma complications). We aim to assess the safety and effectiveness of ‘T-tube’ enterostomy in the management of emergency neonatal intestinal problems. We treated neonates with emergency intestinal problems using ‘T-tube’ enterostomy between July 2016 and March 2020 in the Departments of Pediatric Surgery and Neonatology, King Saud Medical City, Riyadh, Saudi Arabia. We included all premature and term neonates who underwent laparotomy for intestinal problems and had ‘T-tube’ placement …

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“T 管”肠造口术在急诊新生儿肠道问题处理中的应用：病例系列

急诊新生儿肠道问题，如坏死性小肠结肠炎 (NEC)、自发性肠穿孔 (SIP)、肠闭锁、胎粪囊肿和胎粪性肠梗阻，给儿科外科医生和新生儿科医生带来了严峻挑战。造口术和一期吻合术已经使用了几十年，每种方法都有各种优点和缺点。1-4 造口术通常需要用于全身性腹膜炎的病例，以及剖腹手术期间肠道远端部分的灌注和活力有问题的情况。在这些危及生命的情况下，造口形成可提高生存率。5 肠道外置术的主要缺点是需要另一种闭合手术，住院时间长且反复入院。其他缺点包括与造口相关的并发症，例如高输出量损失、电解质紊乱、狭窄、皮肤表皮脱落、造口脱垂或回缩，以及造口旁突出或肠系膜缺损内疝。 1-4 一期吻合应在稳定且局部化的新生儿中进行肠道疾病。6 7 一期吻合的潜在问题是吻合口漏、腹膜炎、吻合口狭窄、淤滞和细菌过度生长。这些是为什么在极低出生体重 (ELBW) 新生儿中不经常尝试一期吻合术的主要原因。8“T 型管”肠造口术是解决各种此类紧急肠道问题的替代技术。9–11“T 型管”结合肠造口术（肠道减压、功能性低输出造口）与一期吻合术（恢复肠道连续性、避免二次手术的需要，避免造口并发症）。我们旨在评估“T 型管”肠造口术在处理急诊新生儿肠道问题中的安全性和有效性。2016 年 7 月至 2020 年 3 月期间，我们在沙特阿拉伯利雅得沙特国王医疗城的小儿外科和新生儿科使用“T 型管”肠造口术治疗了有紧急肠道问题的新生儿。我们包括所有因肠道问题接受剖腹手术并放置“T 型管”的早产儿和足月新生儿…… 2016 年 7 月至 2020 年 3 月期间，我们在沙特阿拉伯利雅得沙特国王医疗城的小儿外科和新生儿科使用“T 型管”肠造口术治疗了有紧急肠道问题的新生儿。我们包括所有因肠道问题接受剖腹手术并放置“T 型管”的早产儿和足月新生儿…… 2016 年 7 月至 2020 年 3 月期间，我们在沙特阿拉伯利雅得沙特国王医疗城的小儿外科和新生儿科使用“T 型管”肠造口术治疗了有紧急肠道问题的新生儿。我们包括所有因肠道问题接受剖腹手术并放置“T 型管”的早产儿和足月新生儿……