Complications of enterostomy and related risk factor analysis of very early onset inflammatory bowel disease with interleukin-10 signalling deficiency: a single-centre retrospective analysis

Abstract

Background Interleukin-10 (IL10) signalling pathway deficiency results in severe very early onset inflammatory bowel disease (VEOIBD), and enterostomy is often inevitable. However, studies in these surgical populations are lacking. This study aims to determine the enterostomy characteristics, postoperative complications and related risk factors in enterostomy patients. Methods From March 1, 2015, to December 31, 2018, patients with IL10R-mutation who underwent enterostomy were recruited for analysis. We collected data on the patients’ clinical characteristics, enterostomy characteristics, postoperative complications and related risk factors. Results Twelve patients required emergency enterostomy, and 10 patients underwent elective enterostomy. Twelve patients experienced postoperative complications, including wound infection (27.3%), wound dehiscence (18.2%), reoperation (18.2%), etc. Compared with the pre-enterostomy values, there was a decrease in C-reactive protein (CRP) (P = 0.001), an increase in albumin (P = 0.001) and an improvement in the weight-for-age (P = 0.029) and body mass index (BMI) Z-scores (P = 0.004) after enterostomy. There was a significant difference between the pre-operation and postoperation medicine expenses (P = 0.002). Univariate binary logistic regression analysis revealed a statistically significant influence of CRP (OR: 1.43, 95% CI: 1.07–1.91, P = 0.016) and a tendency towards a significant influence of intestinal perforation, albumin level, BMI Z-score and weighted paediatric Crohn’s disease activity index (wPCDAI). Multivariate logistic regression analysis showed that CRP (OR: 1.40), wPCDAI (OR: 2.88) and perforation (OR: 1.72) showed a tendency to behave as independent risk factors for postoperative complications, but the results were not significant (all P > 0.05). Conclusions Surgery and enterostomy showed benefits for VEOIBD with IL-10 signalling deficiency. The timing of intervention, potential postoperative complications, economic burden and other related problems should be considered.

Risk factors for stoma-and-incision-related complications in children with very early-onset inflammatory bowel disease: A prospective cohort study

“…Elizabeth et al 16 performed ileostomy on 24 children with refractory IBD and the results showed that improvement in WHZ and hemoglobin, a reduction in hospitalization rates provide further evidence that ileostomy is a successful intervention that promotes clinical stability and provides time and possibility for further treatment. Tang Z et al 21 proposed that enterostomy is bene cial for VEO-IBD with IL-10 defect. This study demonstrated that after enterostomy, in ammatory indicators (ESR, WBC and CRP), wPCDAI and nutritional indicators (albumin and hemoglobin) were improved in children with VEO-IBD who had IL-10 signal loss.…”

“…The results showed that CRP level and wPCDAI were not signi cantly different but tended to become independent risk factors. 21 This paper included 43 VEO-IBD children with stomas. To our knowledge, this is the most signi cant number of children in the analysis of stoma-related complications after enterostomy and their in uencing factors.…”

Long-term outcomes after enterostomy for very early-onset inflammatory bowel disease with interleukin-10 signaling deficiency

“…For severe VEOIBD patients with IL10R gene mutations, enterostomy is always inevitable [10,11]. Our previous single-center retrospective study reported the complications of enterostomy and related risk factors in 22 VEOIBD patients with IL10R gene signaling de ciency [7]. In this study, we collected 46 IL10R gene-mutated patients with enterostomy and followed up on their outcomes after HSCT, especially in uencing factors for stoma closure.…”

“…In our previously reported study, the complications of enterostomy and related risk factor analysis of VEOIBD with IL-10 signaling de ciency in our IBD center were determined [7]. However, the long-term outcomes of these patients after enterostomy are still unclear, and some risk factors for stoma closure are especially unclear.…”

Risk Factors of Enterostomy Infection Caused by Bacterial Infection through Mathematical Modelling-Based Information Data Analysis

“…Among the many complications, the incidence of stoma infection is higher [6]. e common complications of ostomy include wound infections near the stoma, infections caused by sutures, detachment of the stoma mucosa, and complications caused by the patient's own factors.…”