Abstract：
OBJECTIVE: Preserving the ileocecal valve (ICV) has shown significant benefits. We present our experience with 18 infants who underwent ileocecal valve-preservation ileocecostomy (IVPI) with an extremely short distal ileum after primary ileostomy.
METHODS: A retrospective analysis was conducted on IVPI cases between 2014 and 2020. Medical records were reviewed, including birth weight, age, primary diseases, length of ileus stump, surgical time and procedure, time to enteral feeding, postoperative hospital stay, and complications.
RESULTS: Eighteen patients (male: female = 12:6, median birth weight 1305 (750-4000) g, median gestational age 29 + 5 (27 + 6-39 + 6) weeks) were included in the analysis. Causes of surgery included necrotizing enterocolitis (13), ileocecal intestinal atresia (1), ileum volvulus (2), meconium peritonitis (1), and secondary intestinal fistula (1). The median corrected age of ileostomy closure was 3.2 months (2.0-8.0 months). The distance from the distal ileal stoma to the ICV ranged from 0.5 to 2 cm. The median length of the residual bowel was 90 cm (50-130 cm). ICV-plasty was performed in 3 cases due to secondary ICV occlusion or stenosis. All patients resumed feeding within 6 to 11 days after surgery. The postoperative hospital stay ranged from 12 to 108 days (median: 16.5 days). Complications included incisional infections in 2 cases, anastomotic stricture and adhesive ileus in 1 case, nosocomial sepsis and septic shock in 1 case. All children showed normal growth and development during a 6-65 month follow-up.
CONCLUSIONS: IVPI is safe and feasible for infants with an extremely short distal ileal stump. ICV-plasty could be applicable for cases with ileocecal occlusion/stenosis.
METHODS: A retrospective analysis was conducted on IVPI cases between 2014 and 2020. Medical records were reviewed, including birth weight, age, primary diseases, length of ileus stump, surgical time and procedure, time to enteral feeding, postoperative hospital stay, and complications.
RESULTS: Eighteen patients (male: female = 12:6, median birth weight 1305 (750-4000) g, median gestational age 29 + 5 (27 + 6-39 + 6) weeks) were included in the analysis. Causes of surgery included necrotizing enterocolitis (13), ileocecal intestinal atresia (1), ileum volvulus (2), meconium peritonitis (1), and secondary intestinal fistula (1). The median corrected age of ileostomy closure was 3.2 months (2.0-8.0 months). The distance from the distal ileal stoma to the ICV ranged from 0.5 to 2 cm. The median length of the residual bowel was 90 cm (50-130 cm). ICV-plasty was performed in 3 cases due to secondary ICV occlusion or stenosis. All patients resumed feeding within 6 to 11 days after surgery. The postoperative hospital stay ranged from 12 to 108 days (median: 16.5 days). Complications included incisional infections in 2 cases, anastomotic stricture and adhesive ileus in 1 case, nosocomial sepsis and septic shock in 1 case. All children showed normal growth and development during a 6-65 month follow-up.
CONCLUSIONS: IVPI is safe and feasible for infants with an extremely short distal ileal stump. ICV-plasty could be applicable for cases with ileocecal occlusion/stenosis.
摘要：
目的：保留回盲瓣（ICV）已显示出明显的益处。我们介绍了18例婴儿的经验，这些婴儿在初次回肠造口术后接受了回肠瓣膜保留回肠造口术（IVPI），回肠远端极短。
方法：对2014年至2020年的IVPI病例进行回顾性分析。检查了医疗记录,包括出生体重,年龄,原发性疾病,肠梗阻残端的长度，手术时间和程序，肠内喂养的时间，术后住院时间,和并发症。
结果：18例患者（男性：女性=12:6，中位出生体重1305（750-4000）g，中位胎龄29+5(27+6-39+6周)纳入分析.手术原因包括坏死性小肠结肠炎（13），回盲肠闭锁（1），回肠扭转(2),胎粪腹膜炎（1），和继发性肠瘘（1）。回肠造口闭合的校正年龄中位数为3.2个月（2.0-8.0个月）。从远端回肠造口到ICV的距离范围为0.5至2cm。残余肠的中值长度为90cm(50-130cm)。3例因继发性ICV闭塞或狭窄而进行了ICV成形术。所有患者在手术后6至11天内恢复进食。术后住院时间为12～108天（中位数：16.5天）。并发症包括切口感染2例，吻合口狭窄和粘连性肠梗阻1例,医院内败血症及脓毒性休克1例。在6-65个月的随访中，所有儿童均表现出正常的生长发育。
结论：IVPI对于远端回肠残端极短的婴儿是安全可行的。ICV成形术可适用于回盲闭塞/狭窄的病例。
方法：对2014年至2020年的IVPI病例进行回顾性分析。检查了医疗记录,包括出生体重,年龄,原发性疾病,肠梗阻残端的长度，手术时间和程序，肠内喂养的时间，术后住院时间,和并发症。
结果：18例患者（男性：女性=12:6，中位出生体重1305（750-4000）g，中位胎龄29+5(27+6-39+6周)纳入分析.手术原因包括坏死性小肠结肠炎（13），回盲肠闭锁（1），回肠扭转(2),胎粪腹膜炎（1），和继发性肠瘘（1）。回肠造口闭合的校正年龄中位数为3.2个月（2.0-8.0个月）。从远端回肠造口到ICV的距离范围为0.5至2cm。残余肠的中值长度为90cm(50-130cm)。3例因继发性ICV闭塞或狭窄而进行了ICV成形术。所有患者在手术后6至11天内恢复进食。术后住院时间为12～108天（中位数：16.5天）。并发症包括切口感染2例，吻合口狭窄和粘连性肠梗阻1例,医院内败血症及脓毒性休克1例。在6-65个月的随访中，所有儿童均表现出正常的生长发育。
结论：IVPI对于远端回肠残端极短的婴儿是安全可行的。ICV成形术可适用于回盲闭塞/狭窄的病例。
