Factors associated with neonatal ostomy complications

Lockhat, Aliyah; Kernaleguen, Guen; Dicken, Bryan; Manen, Max van

doi:10.1016/j.jpedsurg.2015.09.026

Cited by 14 publications

(11 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Whilst giving some optimism when compared to previously published work 1 3 19 20 21 22 23 24 , these results would suggest there is still some way to go in improving outcomes for infants with NEC. Further improving these outcomes is reliant on highlighting infants who are at higher risk of adverse events.…”

Section: Discussionmentioning

confidence: 74%

A UK wide cohort study describing management and outcomes for infants with surgical Necrotising Enterocolitis

Allin¹,

Long²,

Gupta³

et al. 2017

Sci Rep

View full text Add to dashboard Cite

The Royal College of Surgeons have proposed using outcomes from necrotising enterocolitis (NEC) surgery for revalidation of neonatal surgeons. The aim of this study was therefore to calculate the number of infants in the UK/Ireland with surgical NEC and describe outcomes that could be used for national benchmarking and counselling of parents. A prospective nationwide cohort study of every infant requiring surgical intervention for NEC in the UK was conducted between 01/03/13 and 28/02/14. Primary outcome was mortality at 28-days. Secondary outcomes included discharge, post-operative complication, and TPN requirement. 236 infants were included, 43(18%) of whom died, and eight(3%) of whom were discharged prior to 28-days post decision to intervene surgically. Sixty infants who underwent laparotomy (27%) experienced a complication, and 67(35%) of those who were alive at 28 days were parenteral nutrition free. Following multi-variable modelling, presence of a non-cardiac congenital anomaly (aOR 5.17, 95% CI 1.9–14.1), abdominal wall erythema or discolouration at presentation (aOR 2.51, 95% CI 1.23–5.1), diagnosis of single intestinal perforation at laparotomy (aOR 3.1 95% CI 1.05–9.3), and necessity to perform a clip and drop procedure (aOR 30, 95% CI 3.9–237) were associated with increased 28-day mortality. These results can be used for national benchmarking and counselling of parents.

show abstract

Section: Discussionmentioning

confidence: 74%

A UK wide cohort study describing management and outcomes for infants with surgical Necrotising Enterocolitis

Allin¹,

Long²,

Gupta³

et al. 2017

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Even so, stoma related complications and the need for a second operation to close the stoma are issues of concern. The frequency of ostomy related complications ranges from 18% to 42% following ostomy formation [8–10] and is as high as 70% following ostomy closure. [11–13] Although the decision between PA or DS in the treatment of MI, CIA, and NEC remains an area of controversy, both treatment strategies are accepted as standard surgical modalities.…”

Section: Introductionmentioning

confidence: 99%

The outcome of Bishop-Koop procedure compared to divided stoma in neonates with meconium ileus, congenital intestinal atresia and necrotizing enterocolitis

et al. 2019

View full text Add to dashboard Cite

To determine the potential value and suitability of Bishop-Koop procedure (BK) compared to divided stoma (DS) in neonates with meconium ileus (MI), congenital intestinal atresia (CIA), and necrotizing enterocolitis (NEC). A retrospective data collection from 2000 to 2019 on neonates undergoing BK and DS formation and closure for MI, CIA, and NEC was conducted. Ostomy related complications following both procedures were analyzed. One hundred two consecutive patients managed with a BK (n = 57, 55.8%) and DS (n = 45, 44.2%) for MI (n = 38, 37.2%), CIA (n = 31, 30.5%), and NEC (n = 33, 32.3%) were analyzed. Mean operating time for ostomy creation did not differ significantly between BK and DS groups (156 ± 54 vs 135 ± 66.8 min, P = .08). The prevalence of stoma-related complications following BK and DS formation was 8.7% and 31.1%, respectively ( P = .005). The complication rate after BK and DS closure was 3.5% and 6.7%, respectively ( P = .65). The operating time for ostomy reversal and length of hospital stay after stoma closure were significantly shorter in BK group (82.2 ± 51.4 vs 183 ± 84.5 min and 5.5 ± 2.7 vs 11.3 ± 3.9 days, P < .001). BK procedure is safe, reliable, and suitable technique in neonatal surgery with low complications rate following ostomy creation as well as shorter operating time and length of hospital stay after ostomy closure compared to DS ostomies. Surgeons should keep this technique as an alternative approach in their repertoire.

show abstract

“…Although closure of an ostomy is a common and straightforward procedure, it is not free of complications, and the incidence of anastomotic leaks is reported to be between 1.6 and 31% in children with an increased risk of anastomotic complications, such as peritonitis (NEC) or a size discrepancy between the dilated proximal and the unused distal bowel (MI). In these cases, a two-stage restoration of intestinal continuity using the formation of the diverting enterostomy has been advocated 2 , 13 , 15 , 20 , 31 .…”

Section: Discussionmentioning

confidence: 99%

Bishop-Koop Ostomy Revisited: A “Test-Drive” Intestinal Diversion for Children With Suspected Bowel Dysmotility

Silva

Miranda

FILHO

et al. 2023

ABCD, arq. bras. cir. dig.

View full text Add to dashboard Cite

BACKGROUND: Bishop-Koop ileostomy has been widely used in pediatric patients with the intention of including as much bowel as possible in the intestinal transit early in the management of children with meconium ileus and intestinal atresia. In recent years, we have been using it as an alternative to test the distal bowel function before closure of a previously constructed ostomy in selected children with questionable distal bowel motility. AIMS: The aim of this study was to present our experience with this alternative use of the Bishop-Koop ostomy. METHODS: This is a cross-sectional retrospective review of hospital records, combined with a comprehensive literature review. RESULTS: Seven children were included: five had suspected aganglionosis, one had gastroschisis complicated with ileal atresia, and one had a colonic stricture secondary to necrotizing enterocolitis. In this short series of patients, motility of the distal bowel was correctly assessed in six patients and partially correctly assessed in one patient. One patient did not pass stools per anus after the Bishop-Koop, and he was later confirmed to have Hirschsprung disease. Four patients resumed normal evacuation pattern after closure of the Bishop-Koop. One patient had a Bishop-Koop colostomy because of recurrent enterocolitis after a transanal pull-through. Although he evacuated normally while having the colostomy, the diarrhea recurred after the ostomy was closed. An additional patient, with a severe behavioral problem, did not evacuate per anus after her colostomy was transformed in a Bishop-Koop-type ostomy, despite the apparent presence of normal ganglia in the bowel wall. CONCLUSIONS: Data from the present series allow us to affirm that Bishop-Koop-type ostomy is a safe and efficient procedure that can be used to assess distal bowel function before a definitive transit reconstruction, in children with uncertain motility issues.

show abstract

Factors associated with neonatal ostomy complications

Cited by 14 publications

References 17 publications

A UK wide cohort study describing management and outcomes for infants with surgical Necrotising Enterocolitis

A UK wide cohort study describing management and outcomes for infants with surgical Necrotising Enterocolitis

The outcome of Bishop-Koop procedure compared to divided stoma in neonates with meconium ileus, congenital intestinal atresia and necrotizing enterocolitis

Bishop-Koop Ostomy Revisited: A “Test-Drive” Intestinal Diversion for Children With Suspected Bowel Dysmotility

Contact Info

Product

Resources

About