title: A sutureless technique using cyanoacrylate adhesives when creating a stoma for extremely low birth weight infants.
abstract: OBJECTIVE
  Intestinal perforation and necrotizing enterocolitis (NEC) are neonatal intestinal emergencies that are especially common in premature infants. While prompt surgical intervention, including stoma creation, is often required, the optimal surgical treatment has been controversial because of the substantial risks related to the stoma creation and management. The use of a tissue adhesive may have some advantages over the use of sutures when creating an intestinal stoma in extremely low birth weight (ELBW) infants. The purpose of this report was to present a novel approach for creating a stoma using a tissue adhesive in ELBW infants.
  
  
  METHODS
  A total of eight ELBW infants that underwent laparotomy with the creation of intestinal stomas using cyanoacrylate adhesive at our institution between 2009 and 2014 were enrolled. The clinical parameters, including the length of the operation, intra- and postoperative complications and the outcomes were evaluated.
  
  
  RESULTS
  The median body weight and gestational age at birth were 630 g and 24.3 weeks, respectively. The median age at referral was 11.5 days. The median length of the procedure was 58.5 min, including the inspection and resection of the intestine. All procedures were completed without any intraoperative complications. There were no postoperative complications associated with the stoma. Two patients died of the associated septic status.
  
  
  CONCLUSIONS
  Sutureless enterostomy using cyanoacrylate adhesive is a simple technique which has the potential to reduce the incidence of complications related to the intestinal stoma in ELBW infants.
authors.affiliation: Department of Pediatric Surgery, Hyogo College of Medicine, Nishinomiya, 663-8501 Hyogo Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Nose
authors.affiliation: Department of Pediatric Surgery, Hyogo College of Medicine, Nishinomiya, 663-8501 Hyogo Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sasaki
authors.affiliation: Department of Pediatric Surgery, Hyogo College of Medicine, Nishinomiya, 663-8501 Hyogo Japan.
authors.forename: Ryuta
authors.initials: R
authors.lastname: Saka
authors.affiliation: Department of Neonatology, Hyogo College of Medicine, Nishinomiya, 663-8501 Hyogo Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Minagawa
authors.affiliation: Department of Neonatology, Hyogo College of Medicine, Nishinomiya, 663-8501 Hyogo Japan ; Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, 565-0871 Osaka Japan.
authors.forename: Hiroomi
authors.initials: H
authors.lastname: Okuyama
keywords: Extremely low birth weight infants (ELBW infants); Intestinal perforation; Intestinal stomas; Tissue adhesive glue