ĐẶC ĐIỂM DỊCH TỄ, LÂM SÀNG VÀ CẬN LÂM SÀNG TRẺ MỞ RUỘT RA DA TẠI KHOA SƠ SINH VÀ KHOA HỒI SỨC SƠ SINH BỆNH VIỆN NHI ĐỒNG 2

Abstract

Objective: To describe the epidemiological, clinical, and laboratory characteristics of neonates undergoing enterostomy formation. Methods: This is a prospective case series of 47 neonates who underwent enterostomy formation at Children's Hospital 2 from October 1, 2023, to June 30, 2024. Results: The median postmenstrual age was 37 weeks, with 48,9% being preterm neonates. The median birth weight was 2800g. Enterostomy formation was performed at a median age of 2 days due to anorectal malformations (34,0%) and necrotizing enterocolitis (25,5%). Ileostomy (61,7%) (Group 1) was the most common stoma site, followed by colostomy (36,2%) (Group 2). Neonates with ileostomy and jejunostomy (2,1%) had a mean residual small bowel length of 92,6 cm. Postoperatively, bloodstream infection occurred in 59,6% of neonates, with 30,8% having positive blood cultures. Other complications included intestinal failure (19,2%), short bowel syndrome (19,2%), surgical site infection (8,5%), and septic shock (10,6%), all belonging to Group 1. Additionally, Group 1 required a 20-day longer average time to achieve full enteral nutrition compared to Group 2. The overall mortality rate was 12,8%. Conclusions: Anorectal malformations and necrotizing enterocolitis were the leading indications for enterostomy formation. High rates of infectious complications and prolonged time to achieve full enteral nutrition are challenges in postoperative management. Neonates with ileostomy have a higher risk of complications than those with colostomy. Close monitoring and intensive care are essential for neonates after enterostomal therapy to improve outcomes.