Introduction. Stoma formation in neonates is often a life-saving procedure across a variety of conditions but is still associated with significant morbidity. Tube stoma technique was originally described for short bowel patients, but in selected cases of neonates this approach could prevent the incidence of stoma-related complications. The aim of the study was to evaluate the safety and utility of tube stomas as an alternative to conventional enterostomy in the neonatal population. Material and Methods. A retrospective multicentre analysis of neonates undergoing emergency laparotomy and tube stoma formation between 2005 and 2017 was performed. Tube stoma complications were analysed. The investigation focused on stricture, skin lesion, enteric fistula and prolapse. Results. Thirty-seven neonates underwent tube stoma fashioning during the study period. Tube-stoma complications were limited to three patients (8.1%), with two children (5.4%) requiring additional stoma surgery during the first 30 days because of an enterocutaneous fistula, and one child (2.7%) for bowel stenosis. Conclusions. In select neonates, such as those with proximal enteric stomas, the tube stoma avoids some of the commonly encountered complications (prolapse, skin excoriation). Further prospective studies are needed to validate these findings in order for us to recommend this technique as superior.
Disruptive 3D technologies, such as reverse engineering (RE) and additive manufacturing (AM), when applied in the medical field enable the development of new methods for personalized and non-invasive treatments. When referring to the monitoring of pectus excavatum, one of the most common thoracic malformations, 3D acquisition of the patient chest proved to be a straightforward method for assessing and measuring chest deformation. Unfortunately, such systems are usually available in a dedicated facility, can be operated only by specialized doctors with the support of engineers and can be used only with patients on site. It is therefore impossible to perform any routine check-up when the patient is unable to reach the outpatient clinic. The COVID19 pandemic situation has placed even greater restrictions on patient mobility, worsening this problem. To deal with this issue, a new low-cost portable optical scanner for monitoring pectus excavatum is proposed in this work. The scanner, named Thor 2.0, allows a remote diagnostic approach, offering the possibility to perform routine check-ups telematically. Usability tests confirmed the user-friendly nature of the devised system. The instrument was used at the Meyer Children’s Hospital (Florence, Italy) chest-malformations center to treat PE patients. The performed measurements proved to be in line with the current state of the art.
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