Juyoung Lee1, Min-Jung Kang2, Han-Suk Kim3, Seung-Han Shin1, Hyun-Young Kim4, Ee-Kyung Kim1, Jung-Hwan Choi1. 1. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea. 2. Department of Medical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea. 3. Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address: kimhans@snu.ac.kr. 4. Department of Pediatric Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
Abstract
BACKGROUND: For premature infants with advanced acute abdomen, creating a temporary enterostomy is believed to be an appropriate surgical management. However, there is no consensus regarding the timing of enterostomy reversal. The aim of this study was to determine the optimal timing for enterostomy closure (EC) by analyzing EC-related complications. METHODS: This was a retrospective study of preterm infants who underwent enterostomy for suspected acute abdomens and subsequent closure. RESULTS: EC-related complications occurred in 35 of 54 infants (65%). A univariate analysis determined the following risk factors for EC-related complications: lower weight and younger age at the time of EC and a shorter stoma duration. In a multiple logistic regression analysis, the only significant risk factor was a weight under 2660 g at the time of the closure operation. Infants with EC-related complications were ventilated longer, were administered more vasopressors, and were more likely to undergo reoperation. Additionally, these infants required parenteral nutrition for a longer duration, had a longer length of hospital stay after EC, and had a significantly lower weight and height at a corrected age of 7-10 months than infants without EC-related complications. CONCLUSION: Body weight may be one of the most important factors to consider for minimizing EC-related complications.
BACKGROUND: For premature infants with advanced acute abdomen, creating a temporary enterostomy is believed to be an appropriate surgical management. However, there is no consensus regarding the timing of enterostomy reversal. The aim of this study was to determine the optimal timing for enterostomy closure (EC) by analyzing EC-related complications. METHODS: This was a retrospective study of preterm infants who underwent enterostomy for suspected acute abdomens and subsequent closure. RESULTS:EC-related complications occurred in 35 of 54 infants (65%). A univariate analysis determined the following risk factors for EC-related complications: lower weight and younger age at the time of EC and a shorter stoma duration. In a multiple logistic regression analysis, the only significant risk factor was a weight under 2660 g at the time of the closure operation. Infants with EC-related complications were ventilated longer, were administered more vasopressors, and were more likely to undergo reoperation. Additionally, these infants required parenteral nutrition for a longer duration, had a longer length of hospital stay after EC, and had a significantly lower weight and height at a corrected age of 7-10 months than infants without EC-related complications. CONCLUSION: Body weight may be one of the most important factors to consider for minimizing EC-related complications.
Authors: Clara Chong; Jacqueline van Druten; Graham Briars; Simon Eaton; Paul Clarke; Thomas Tsang; Iain Yardley Journal: Eur J Pediatr Date: 2019-09-14 Impact factor: 3.183