Kyoko Mochizuki1, Masahiro Hayakawa2, Naoto Urushihara3, Hiromu Miyake3, Akiko Yokoi4, Jun Shiraishi5, Hideshi Fujinaga6, Kensuke Ohashi7, Genshiro Esumi8, Satoko Ohfuji9, Shintaro Amae10, Toshihiro Yanai11, Taizo Furukawa12, Yuko Tazuke13, Kyoko Minagawa14, Hiroomi Okuyama13. 1. Department of Surgery, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama, 232-0066, Japan. kmochizuki@kcmc.jp. 2. Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan. 3. Department of Pediatric Surgery, Shizuoka Children's Hospital, Shizuoka, Japan. 4. Department of Pediatric Surgery, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan. 5. Department of Neonatology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan. 6. Division of Neonatology, Center for Maternal-Fetal and Neonatal Medicine, National Center for Child Health and Development, Tokyo, Japan. 7. Department of Pediatric Surgery, Nihon University School of Medicine, Tokyo, Japan. 8. Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 9. Department of Public Health, Osaka University Faculty of Medicine, Osaka, Japan. 10. Department of Pediatric Surgery, Miyagi Children's Hospital, Sendai, Japan. 11. Department of Pediatric Surgery, Ibaraki Children's Hospital, Mito, Japan. 12. Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. 13. Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Japan. 14. Department of Pediatrics, Hyogo College of Medicine, Hyogo, Japan.
Abstract
PURPOSE: Very low birth weight infants (VLBWIs) are at risk of surgical intestinal disorders including necrotizing enterocolitis (NEC), focal intestinal perforation (FIP), and meconium-related ileus (MRI). We conducted this study to verify whether the timing of stoma closure and that of enteral nutrition establishment after stoma closure in VLBWIs differ among the most common disorders. METHODS: A retrospective multicenter study was conducted at 11 institutes. We reviewed the timing of stoma closure and enteral nutrition establishment in VLBWIs who underwent stoma creation for intestinal disorders. RESULTS: We reviewed the medical records of 73 infants: 21 with NEC, 24 with FIP, and 25 with MRI. The postnatal age at stoma closure was 107 (28-359) days for NEC, 97 (25-302) days for FIP, and 101 (15-264) days for MRI (p = 0.793), and the postnatal age at establishment of enteral nutrition was 129 (42-381) days for NEC, 117 (41-325) days for FIP, and 128 (25-308) days for MRI (p = 0.855). The body weights at stoma closure were 1768 (620-3869) g for NEC, 1669 (1100-3040) g for FIP, and 1632 (940-3776) g (p = 0.614) for MRI. There were no significant differences among the three groups. CONCLUSIONS: The present study revealed that the time and body weights at stoma closure and the postoperative restoration of bowel function in VLBWIs did not differ among the three diseases.
PURPOSE: Very low birth weight infants (VLBWIs) are at risk of surgical intestinal disorders including necrotizing enterocolitis (NEC), focal intestinal perforation (FIP), and meconium-related ileus (MRI). We conducted this study to verify whether the timing of stoma closure and that of enteral nutrition establishment after stoma closure in VLBWIs differ among the most common disorders. METHODS: A retrospective multicenter study was conducted at 11 institutes. We reviewed the timing of stoma closure and enteral nutrition establishment in VLBWIs who underwent stoma creation for intestinal disorders. RESULTS: We reviewed the medical records of 73 infants: 21 with NEC, 24 with FIP, and 25 with MRI. The postnatal age at stoma closure was 107 (28-359) days for NEC, 97 (25-302) days for FIP, and 101 (15-264) days for MRI (p = 0.793), and the postnatal age at establishment of enteral nutrition was 129 (42-381) days for NEC, 117 (41-325) days for FIP, and 128 (25-308) days for MRI (p = 0.855). The body weights at stoma closure were 1768 (620-3869) g for NEC, 1669 (1100-3040) g for FIP, and 1632 (940-3776) g (p = 0.614) for MRI. There were no significant differences among the three groups. CONCLUSIONS: The present study revealed that the time and body weights at stoma closure and the postoperative restoration of bowel function in VLBWIs did not differ among the three diseases.