Enterostomy-related complications and growth following reversal in infants.
BACKGROUND
Infant enterostomies are used to manage various neonatal surgical conditions where it is not suitable or safe to form a primary anastomosis. Complications are common and there is no consensus regarding optimal timing of enterostomy reversal. Stoma reversal is thought to allow patients to thrive; however, this has not been demonstrated robustly.


OBJECTIVE
The study aimed to identify risk factors for enterostomy-related complications and to determine the relationship between enterostomy complications, enterostomy reversal and weight gain in infants with enterostomies.


METHODS
A retrospective case note review of 58 infants who underwent enterostomy formation and reversal during a 6-year period was undertaken; demographic data, diagnosis, enterostomy complications and serial weights were noted. Standardised growth charts were used to calculate z scores.


RESULTS
Enterostomy complications were documented in 24 infants (41%). Infants of low birth weight and low gestational birth age were significantly more likely to have an enterostomy-related complication (1110 vs 2125 g, 28.5 vs 35 weeks, respectively); they were more likely to have longer inpatient stays and remain dependent on parenteral nutrition prior to closure (median 92.5 vs 52 days, 40% vs 16%, respectively). Irrespective of diagnosis, gestation and presence of an enterostomy complication, the mean z score prior to enterostomy closure was -0.747 vs +0.892 following closure.


CONCLUSIONS
Around 40% of infants with an enterostomy will have an enterostomy-related complication. Whatever their weight, gestation or underlying pathology, most infants thrive after enterostomy closure and this should be considered when planning the optimal timing for this procedure.
Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, UK.|University of Liverpool Institute of Translational Medicine, Liverpool, UK.
George
http://orcid.org/0000-0002-1302-0735
G
Bethell
Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, UK.|University of Liverpool Institute of Translational Medicine, Liverpool, UK.
Simon
S
Kenny
Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Liverpool, UK.
Harriet
H
Corbett
D058107:Abdominal Wound Closure Techniques; D001724:Birth Weight / Q000502:physiology; D004766:Enterostomy / Q000009:adverse effects*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D015430:Weight Gain / Q000502:physiology*
Growth; Neonatology; Paediatric Surgery