Multidisciplinary doctors worked together The 2.6 kg anus-free baby successfully completed the transverse colostomy

BEIJING, Jan.
11, 2023 /PRNewswire/ -- This round of coronavirus infections has put new demands
on the service capacity of medical institutions.
Recently, a 2.
6-kilogram baby who was only one day old successfully completed a transverse colostomy at UFH Jingbei Women's and
Children's Hospital.
In addition to putting forward technical tests for the doctor team and anesthesia team, it also poses a lot of challenges to the software and hardware environment and management system of
medical institutions.

Online multidisciplinary consultation "free baby" completed transverse colostomy one day after birth

On December 12, a "special" baby fell to the ground
at Beijing United Family Jingbei Women's and Children's Hospital.
Why say "special"?

Because the fetus was found to have no meconium discharge, the hospital immediately organized a consultation with a pediatric surgeon, and later diagnosed the boy with congenital atresia and considered the possibility of
urethral and rectal fistula.

For babies with congenital atresia, time is the most urgent
.
In this regard, the hospital broke the offline consultation process after routine ward rounds, and after front-line doctors did a good job of protective ward rounds and summarized the data together, Yang Ming, medical director of UFH Jingbei Women's and Children's Hospital, led an online MDT meeting (multidisciplinary consultation)
for the first time.
This fully protects mothers and children from the additional risk of
virus infection during the climbing phase of the city's new crown infection rate.

Medium to high obstruction, small baby, need to be performed under general anesthesia, need to be re-anorectal formation and urethral fistula repair in the later stage.
.
.
Surgery faces a range of difficulties and risks
.
However, in order to gain the opportunity for treatment, the consulting team decided to operate
quickly.
On the morning of December 13th, with the assistance of the anesthesiology team, Dr.
Zhang Qinming, director of the Department of Pediatric Surgery, and Dr.
Guo Yufeng performed transverse colostomy
under general anesthesia for a one-day-old baby.
With the team's meticulous preoperative preparation and intraoperative cooperation, the operation was successfully completed
.

After the operation, the baby was able to feed normally through mouth and defecate through the ostomy oral, recovered well in the past three days, and was discharged from the hospital on December 13, and the hospital will pay attention to the baby's health and provide follow-up medical services
.

Rectal and malformations require prompt surgery The United Family Healthcare Fund treats sick abandoned babies every year

Zhang Qinming, director of pediatric surgery and emergency director of UFH Jingbei Women's and Children's Hospital, said that 40% to 50% of children with "congenital rectal and malformations", including absence and stenosis, will have urinary diseases and heart malformations
.
For newborns with atresia without fistula, once the condition exceeds 5 days, symptoms of systemic poisoning may occur, and untimely surgery will cause intestinal obstruction, intestinal perforation or intestinal necrosis - early surgery is the solution
.

The Beijing United Family Healthcare Foundation donates 1% of its annual operating income to provide timely assistance to vulnerable groups in China, including children who have given up treatment due to family difficulties and abandoned babies in welfare institutions, and 20 or 30 children rescued each year involve pediatric surgery, of which nearly half are gastrointestinal malformations including rectal and malformations
.

"In fact, such children are only born defects, and after surgical treatment, the vast majority of children can live
like normal people.
" Zhang Qinming introduced that children can generally recover their own control of bowel movements after surgical treatment, which is no different from
normal children.
However, no matter how young the child is and how poor the physical fitness, the disease is an emergency surgery and needs to be treated
as soon as possible.

Among the children treated by Zhang Qinming's team, the most difficult operation was a baby girl with a "one-point" deformity, that is, the urethral rectum and vagina grow together, and there is Down syndrome
.
Although the operation was difficult, with the cooperation of multiple departments, the operation was successfully completed and achieved good postoperative results, and now the baby girl has resumed her own defecation and found a foster family, and her life that was once in danger has been extended
.
"Every life deserves to be cared
for.
UFH has the ability and strength to help these babies and bring them new hope
.
"

Multidisciplinary cooperation for early detection and early intervention to ensure the safe "landing" of newborns

The safe "landing" of newborns not only tests the "early detection" of the medical team, but also tests the ability
of multiple disciplines of the entire medical institution to intervene and treat together.

Under the current situation of general shortage of medical resources, UFH's medical resources and management system provide better security
for pregnant women and newborns.
First, single rooms reduce the risk of cross-infection, and rooming also reduces separation anxiety
for mother and baby.
At the same time, the whole one-stop service ensures that when the mother and newborn encounter problems, the operation is carried out as soon as possible after delivery, reducing the cumbersome process
of outpatient appointment surgery.

In addition, the perfect postoperative follow-up system escorts the whole process of recovery for children
.
Taking "baby" as an example, the nurse team that works with the medical team will carefully teach parents after the operation: how to care for the fistula after the fistula, how to change the fistula bag, etc
.
Regular follow-up and full monitoring until the next operation
.

Neonatal surgical anesthesia is a pass, the whole process of monitoring a number of indicators, the anesthesia team "excellence"

For neonatal surgery, anesthesia is also a "checkpoint"
.
If there is a problem with the control of the perioperative anesthetic fluid, hypoxia, acidosis, and hypothermia in the infant may lead to dangerous conditions
such as heart failure or severe dehydration.

"The fetal to adult circulation is completed in the neonatal period (the first two or three weeks), and if there are iatrogenic imperfections during the operation, a 2.
6 kg child is undoubtedly at greater risk, and a little more anesthesia may lead to heart failure
。 Li Xiaokui, deputy medical director and director of the anesthesiology department of Beijing United Family Jingbei Women's and Children's Hospital, said that during the operation, every time the child's heart rate and blood pressure fluctuate slightly, the anesthesiologist needs to conduct an assessment: is it a painful stimulus or does it need to replenish the amount of anesthesia intake? Is the supplement a step or a gradual process? "These are tests of the skills of anesthesiologists
.
"

It is worth mentioning that for pediatric surgery, UFH's medical charges have very clear standards, neonatal surgery needs to be strengthened and there is a monitoring mechanism to supervise implementation
.
For example, pediatric surgery requires that two anesthesiologists authorized for pediatric surgery be on site
.
In this operation of "baby", the anesthesia team overcame the current difficulties of the epidemic and ensured that three senior anesthesiologists were on
site throughout the operation by strengthening protection and adjusting shifts.

In the first day of birth, the heart, lungs, brain, kidney and other organs and systems are not mature, and it is particularly important
to maintain the child's respiratory circulation, acid-base balance and blood sugar during surgery.
In order to maintain the baby's body temperature, the operating room and anesthesiology department made a preoperative plan, adjusted the indoor temperature to 28 to 30 degrees Celsius, and the doctor wearing an isolation gown sweated
profusely after an operation.
But even so, all personnel put the baby's needs first
.

The entire operation lasted 80 minutes, plus the preparation and the time spent waiting for the baby to resume spontaneous breathing after the operation, and the baby returned to the mother in less than four hours
.