Application of Santulli enterostomy in the treatment of neonatal necrotizing enterocolitis: a retrospective cohort study

The Santulli enterostomy (SE) has been used as a clinical surgical treatment of necrotizing enterocolitis (NEC) in few studies which enrolled small number cases or lacked control group. Our study aimed to compare the clinical safety and efficacy of Santulli enterostomy with single- or double-lumen enterostomy in neonatal NEC through a retrospective cohort study. 110 patients met the criteria were divided into the SE group with 64 cases and the conventional enterostomy group with 46 cases who underwent single- or double-lumen enterostomy. There were no significant differences in complications and prognoses between the two groups after enterostomy. The stoma location in the SE group was higher (20 [11,37] cm vs 10 [4.5,15,5] cm), but the unused small intestine (USI) length was not significantly different (13 [5,20] cm vs 10 [4.5,15,5] cm). Multivariate analysis showed that USI length was the influence factor of malnutritional status after enterostomy (OR=1.103, P<0.001). The operation time, intestinal recovery time, fasting time, hospitalization time and intraoperative blood loss were all significantly less and the incidence of complications was lower in the SE group after stoma closure. Multivariate analysis showed that SE was a protective factor for complications after stoma closure (OR=0.036, P=0.006). Santulli enterostomy is a safe treatment option for NEC and can increase the effective utilization length of the small intestine after enterostomy, thereby improving the postoperative nutritional status. In addition, it enhances the recovery process and reduces the incidence of complications after stoma closure.