title: [Intestinal stomas. Are they as simple as they seem?]
abstract: OBJECTIVE
  To examine the morbidity and mortality of the formation and closure of enterostomies.
  
  
  METHODS
  Retrospective study between 2000-2014 of patients younger than 14 years old who underwent an enterostomy. We evaluated: surgical technique, underlying pathology, general and stoma complications, sex, age and weight at the time of formation. At the closure we evaluated: surgical technique, age, weight, hemoglobin, hematocrit and albumin, as well as complications.
  
  
  RESULTS
  We performed 120 enterostomies in 114 patients: 69 (57.5%) colostomies, 43 (35.8%) ileostomies and 8 (6.7%) yeyunostomy. The most frequent causes were: anorectal malformation (45/69), necrotizing enterocolitis (24/43) and intestinal atresia (4/8) respectively. 39 (32.5%) complications related to the stoma (colostomy 21, Ileostomy 15, Yeyunostomy 3; p= 0.845), 11 (9.2%) required surgery (colostomy 8, Ileostomy 2, Yeyunostomy 1; p= 0.439), and 17 (14.2%) general complications (colostomy 9, Ileostomy 7, Yeyunostomy 1; p= 0.884). We found a higher rate of complications requiring surgery in loop enterostomy 8/38 (21.1%), separated 3/54 (5.3%) or double-barrel 0/25 (p= 0.007). We closed 96 (80%), presenting complications in 14; yeyunostomy 4/6 (66.7%), colostomies 5/59 (8.5%), ileostomies 5/31 (16.1%) (p= 0.001). Hematocrit and hemoglobin below age average, and albumin under normal values are associated with complications when closing enterostomies (p< 0.05). Six patients (25%) who didn't went to closure died as a result of the underlying pathology and 5 (20.8%) of other causes.
  
  
  CONCLUSIONS
  The formation and closing of enterostomies remains a procedure with a high rate of complications. However, there are no clear risk factors, excepting the use of loop enterostomy and lower albumin, hemoglobin or hematocrit at the time of closure.
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Infantil Miguel Servet. Zaragoza.
authors.forename: P
authors.initials: P
authors.lastname: Bragagnini Rodríguez
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Infantil Miguel Servet. Zaragoza.
authors.forename: Y
authors.initials: Y
authors.lastname: González Ruiz
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Infantil Miguel Servet. Zaragoza.
authors.forename: R
authors.initials: R
authors.lastname: Fernández Atuán
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Infantil Miguel Servet. Zaragoza.
authors.forename: N
authors.initials: N
authors.lastname: González Martínez-Pardo
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Infantil Miguel Servet. Zaragoza.
authors.forename: P
authors.initials: P
authors.lastname: Burgués Prado
authors.affiliation: Servicio de Cirugía Pediátrica. Hospital Infantil Miguel Servet. Zaragoza.
authors.forename: J
authors.initials: J
authors.lastname: Elías Pollina
mesh_terms: D000293:Adolescent; D002648:Child; D003125:Colostomy / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data; D007582:Jejunostomy / Q000009:adverse effects / Q000401:mortality / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Colostomy; Complications; Enterostomy; Ileostomy