Timing and outcome of stoma closure in very low birth weight infants with surgical intestinal disorders

Surg Today. 2017 Aug;47(8):1001-1006. doi: 10.1007/s00595-017-1498-6. Epub 2017 Feb 28.

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.

Keywords: Focal intestinal perforation; Meconium-related ileus; Necrotizing enterocolitis; Stoma closure; Very low birth weight infants.

MeSH terms

  • Age Factors
  • Body Weight
  • Enteral Nutrition
  • Enterocolitis, Necrotizing / surgery*
  • Female
  • Humans
  • Ileus / surgery*
  • Infant
  • Infant, Newborn
  • Infant, Very Low Birth Weight*
  • Intestinal Perforation / surgery*
  • Male
  • Meconium*
  • Multicenter Studies as Topic
  • Retrospective Studies
  • Risk
  • Surgical Stomas*
  • Time Factors
  • Treatment Outcome