COMPARISON BETWEEN OUTCOME OF CHIMNEY ENTEROSTOMY AND MIKULICZ ENTEROSTOMY FORMATION IN PATIENTS OF COMPLICATED MECONIUM ILEUS

Abstract

Objective: To compare the outcome of Bishop- Koop chimney enterostomy and Mikulicz enterostomy formation among patients with complicated meconium ileus. 

Study Design: Randomized Controlled trial.

Selling: Pediatric Surgery Department, Nishtar Hospital, Multan.  

Duration: 06 months after approval of synopsis from: December 2024 to May 2025.

Methodology: Following IERB approval, 102 neonates/infants were recruited. After informed consent, they were randomized into two groups: Group A (Bishop-Koop) and Group B (Mikulicz Enterostomy), 51 cases in each group. Postoperative outcomes including anastomotic leakage, high-output diarrhea, and sepsis were recorded for comparison.

Results: Group-A had significantly more males (p = 0.028), while gestational age and birth weight were similar across groups. Anastomotic leakage (37.3% vs. 15.7%; p = 0.014) and sepsis (51.0% vs. 25.5%; p = 0.008) were significantly higher in Group-A. No cases of high-output stoma were observed in either group. Stratified analysis showed worse outcomes in Group-A among males and patients with gestational age >36 weeks or birth weight >3 kg. Hospital stay was slightly longer in Group-B, but the difference was not statistically significant.

Conclusion: Mikulicz Enterostomy proved safer and more effective than Chimney Enterostomy in reducing postoperative complications in complicated meconium ileus. These findings support its use in similar clinical settings, with further studies needed for long-term validation.