Peculiarities of management of children with intestinal stomas of different localization in the neonatal period
https://doi.org/10.37489/2949-1924-0101
EDN: MBYUNI
Abstract
Intestinal stoma formation in neonates with severe gastrointestinal diseases or congenital malformations remains a critical and challenging issue in neonatology. Postoperatively, preventing associated complications-such as high enteric stoma losses, electrolyte imbalances, malabsorption syndrome, cholestasis, and small intestinal bacterial overgrowth — is equally urgent. Effective neonatal resuscitation with intensive stabilization, comprehensive monitoring, homeostasis correction, and infection control is essential. Early initiation of enteral nutrition (starting with trophic feeds and gradually advancing based on the preserved bowel’s capacity) alongside parenteral support is crucial post-surgery. Breast milk provision and maternal involvement in stoma care are vital components.
The ultimate goal of management is to prepare the infant for definitive reconstructive surgery.
Supporting agencies: The work was carried out without sponsorship. None of the authors has a financial interest in the mate- rials or methods presented
About the Authors
E. A. Kupriyanova
Yaroslavl State Medical University
Russian Federation
Competing Interests:
Russian Federation
Ekaterina A. Kupriyanova, pediatrician, resident neonatologist
IPO; Department of Pediatrics
Yaroslavl
Competing Interests:
Authors declare no conflict of interest requiring disclosure in this article
Ya. S. Mirzoeva
Yaroslavl State Medical University
Russian Federation
Competing Interests:
Russian Federation
Yana S. Mirzoeva, therapist, resident neonatologist
IPO; Department of Pediatrics
Yaroslavl
Competing Interests:
Authors declare no conflict of interest requiring disclosure in this article
N. Yu. Siluyanova
Yaroslavl State Medical University; Regional Children’s Clinical Hospital
Russian Federation
Competing Interests:
Russian Federation
Natalia Yu. Siluyanova, assistant, Head of the Unit, Chief External Neonatology Specialist, Ministry of Health of the Yaroslavl Region
IPO; Department of Pediatrics; Department of Phthisiology; Neonatal Intensive Care Unit
Yaroslavl
Competing Interests:
Authors declare no conflict of interest requiring disclosure in this article
L. E. Stroeva
Yaroslavl State Medical University
Russian Federation
Competing Interests:
Russian Federation
Larisa E. Stroeva, Cand. Sci. (Med.), Associate Professor
IPO; Department of Pediatrics
Yaroslavl
Competing Interests:
Authors declare no conflict of interest requiring disclosure in this article
References
1. Ivanov S.D., Slizovskij G.V., Balaganskiy D.A, et al. Outcomes of surgical treatment of neonates with intestinal stomas in a regional perinatal center. Detskaya khirurgiya (Russian Journal of Pediatric Surgery) 2021; 25(3): 158-164. (In Russ.) doi: 10.18821/1560-9510-2021-25-3-158-164
2. Minaev S.V., Bykov N.I., Isaeva A.V. et al. The complications of intestinal stoma in children. Pirogov Russian Journal of Surgery. 2017;(1):54-57. (In Russ.) doi: 10.17116/hirurgia2017154-57
3. Naumova N.A., Leontyeva E.A. Nuances of Managing Patients with Inflammatory Bowel Diseases. First Medical TV Channel. Lecture. 2023.
4. Valker F.I. The Development of Human Organs After Birth. Leningrad: Medgiz, 1951. 190 p.
5. Korpela K, Mutanen A, Salonen A, Savilahti E, de Vos WM, Pakarinen MP. Intestinal Microbiota Signatures Associated With Histological Liver Steatosis in Pediatric-Onset Intestinal Failure. JPEN J Parenter Enteral Nutr. 2017 Feb;41(2):238-248. doi: 10.1177/0148607115584388.
6. Averyanova Yu.V., Batyrshin E.M., Demko A.E. et al. Clinical recommendations of the Northwest Society for Enteral and Parenteral Nutrition, Interregional Association for Emergency Surgery, Russian Gastroenterological Association, Union of Rehabilitation Therapists of Russia and Russian Transplantation Society on diagnosis and treatment of short bowel syndrome-associated intestinal failure in adults. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2022;32(1):60–103. doi: 10.22416/1382-4376-2022-32-1-60-103.
7. Ivanov S.D., Slizovskij G.V., Shikunova J.V. Enterostomy in neonates : relevant review of surgical treatment. Ros Vestn Perinatol i Pediatr 2022; 67:(1): 21–27 (in Russ.). doi: 10.21508/1027-4065-2022-67-1-21-27
8. Yerpulyova, Yu.V., Chubarova, A.I., Chugunova, O.L. (Eds.). (2016). Parenteral and enteral nutrition in children : Practical guidelines; GEOTAR-Media 2016.
9. Chubarova A.I. Therapeutic enteral and parenteral nutrition of newborns. National Guidelines. Moscow: GEOTAR-Media; 2014;653-692.
10. Grosheva EV, Degtyarev DN, Ionov OV, et al. Draft clinical protocol "Parenteral nutrition of newborns". Neonatologiya: novosti, mneniya, obuchenie 2013;(2):89-97.
11. New D. Gastroenterology and Nutrition: Neonatology Challenges and Controversies [Russian translation edited by Yu.G. Mukhina]. Moscow: Logosphere; 2014.
12. Belza C, Fitzgerald K, de Silva N, Avitzur Y, Steinberg K, Courtney-Martin G, Wales PW. Predicting Intestinal Adaptation in Pediatric Intestinal Failure: A Retrospective Cohort Study. Ann Surg. 2019 May;269(5):988-993. doi: 10.1097/SLA.0000000000002602.
13. Isakov YuF, Volodin NN, Geraskin AV. Neonatal Surgery. Moscow: Dinastiya; 2011. 680 p.
14. Averyanova Yu.V., Vessel L., Erpulyova Yu.V. et al. Federal clinical recommendations «treatment of children with the short bowel syndrome». Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2014;4:92-108.
15. Erpuleva Yu.V., Chubarova A.I. Modern Management of Children with Short Bowel Syndrome and Other Forms of Chronic Intestinal Failure. A Guide for Physicians. Moscow: GEOTAR-Media, 2016. 150 p.
16. Chubarova A.I. Algorithm for Selecting Enteral Nutrition in Newborns with Surgical Diseases of the Intestine. In: Proceedings of the 5<sup>th</sup> Congress of the Scientific Society of Gastroenterologists of Russia and the 32<sup>nd</sup> Session of the Central Research Institute of Gastroenterology. Moscow, 2005. P. 507.
17. Skvortsova V.A., Borovik T.E., Netrebenko O.K. et al. The role of breast milk in nutrition and care of preterm infants. Pediatrics. Journal named after G.N. Speransky. 2015;5
18. Patel AL, Johnson TJ, Engstrom JL, et al. Impact of early human milk on sepsis and health-care costs in very low birth weight infants. J Perinatol. 2013 Jul;33(7):514-9. doi: 10.1038/jp.2013.2.
19. Ben XM, Li J, Feng ZT, Shi SY, Lu YD, Chen R, Zhou XY. Low level of galacto-oligosaccharide in infant formula stimulates growth of intestinal Bifidobacteria and Lactobacilli. World J Gastroenterol. 2008 Nov 14;14(42):6564-8. doi: 10.3748/wjg.14.6564.
20. Ou J, Courtney CM, Steinberger AE, Tecos ME, Warner BW. Nutrition in Necrotizing Enterocolitis and Following Intestinal Resection. Nutrients. 2020 Feb 18;12(2):520. doi: 10.3390/nu12020520.
21. Grosheva E.V., Zubkov V.V. Management of enteral nutrition of premature newborns who have undergone conservative necrotizing enterocolitis as the basis for favorable short and long-term outcomes. Neonatologiya: novosti, mneniya, obuchenie. 2021;9(2):33–9. doi: 10.33029/2308-2402-2021-9-2-33-39 (in Russ.)
22. Bishay M, Pichler J, Horn V, Macdonald S, Ellmer M, Eaton S, Hill S, Pierro A. Intestinal failure-associated liver disease in surgical infants requiring long-term parenteral nutrition. J Pediatr Surg. 2012 Feb;47(2):359-62. doi: 10.1016/j.jpedsurg.2011.11.032.
23. Erpuleva Yu.V., Chubarova A.I., Vainshtein N.P. et al. Complications of long-term parenteral nutrition in newborns and infants. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2017;7(1):59-69.
24. Ionov A.L., Shcherbakova O.V., Sulavko Ya.P. et al. Peristomal complications and principles of intestinal stoma care in children. Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2011;4:3-11.
25. Logunova Yu. What to Do Next: A Brief Guide to Stoma Care for Parents of Special Needs Children and Junior to Intermediate Medical Staff. Moscow: R. Valent; 2014. 124 p.
26. Melville CA, Bisset WM, Long S, Milla PJ. Counting the cost: hospital versus home central venous catheter survival. J Hosp Infect. 1997 Mar;35(3):197-205. doi: 10.1016/s0195-6701(97)90207-3.
Review
For citations:
Kupriyanova E.A., Mirzoeva Ya.S., Siluyanova N.Yu., Stroeva L.E. Peculiarities of management of children with intestinal stomas of different localization in the neonatal period. Patient-Oriented Medicine and Pharmacy. 2025;3(3):40-49. (In Russ.) https://doi.org/10.37489/2949-1924-0101. EDN: MBYUNI
Views:
41
.png)
Email this article 