T-TUBE ENTEROSTOMY: TECHNICAL CONSIDERATIONS AND CLINICAL APPLICATIONS

Introduction: T-tube enterostomy is a minimally invasive technique for temporary gastrointestinal decompression in pediatric patients, particularly neonates and infants. Traditional enterostomy methods often lead to complications and prolonged recovery, highlighting the need for alternative approaches. Materials and methods: This study evaluates the outcomes of 33 patients under one year of age who underwent T-tube enterostomy at St. Anna Hospital, Varna (2008–2021). The cohort included neonates with low birth weight and gastrointestinal conditions, such as bowel obstruction, meconium ileus, and necrotizing enterocolitis. Results: The procedure, performed via a supraumbilical transverse laparotomy, prioritized organ preservation and minimized trauma. The T-tube was placed using standardized techniques, with adjustments based on patient anatomy. Clinical outcomes confirmed its effectiveness in providing gastrointestinal decompression while enabling intraoperative and postoperative lavage. The mean T-tube retention was 14 days, with spontaneous fistula closure after removal, eliminating the need for additional surgery. No significant complications were observed. Compared to conventional enterostomy, the T-tube method offers reduced invasiveness, shorter operative time, spontaneous fistula closure, and improved postoperative management. Its multifunctionality also facilitates medication administration and contrast studies. Conclusion: In conclusion, T-tube enterostomy is a safe and effective alternative for managing neonatal and infant gastrointestinal conditions, supporting its use as a preferred surgical technique.