Prospective Evaluation of Early Complications After Elective Loop Ileostomy: Need to Optimise Loperamide Management?

Bolckmans, Roel; C, Jean-Baptiste; Singh, Seema; Stephen, Boyce; D’Hoore, André; Albert, W

doi:10.1007/s11605-021-05148-1

Cited by 2 publications

(2 citation statements)

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“…In recent years, patient series, 8 proposed management strategies, 2,4,9–13 and statement guidelines 1,14 were published focussing on the management of high‐output stoma in adults, but evidence specifically for the therapeutic approach of paediatric intestinal failure by high‐output enterostomy seems to be poor and mainly based on personal experience (i.e., practice‐based) 3,4 . Therefore, this systematic review sought to clarify the therapeutic approach of a high‐output enterostomy in children.…”

Section: Introductionmentioning

confidence: 99%

“…5 A structured therapeutic approach to manage a high-output enterostomy with concomitant (risk for) intestinal failure is of vital importance to limit shortterm complications as well as mental and physical sequels on the long-term. 6,7 In recent years, patient series, 8 proposed management strategies, 2,4,[9][10][11][12][13] and statement guidelines 1,14 were published focussing on the management of highoutput stoma in adults, but evidence specifically for the therapeutic approach of paediatric intestinal failure by high-output enterostomy seems to be poor and mainly based on personal experience (i.e., practice-based). 3,4 Therefore, this systematic review sought to clarify the therapeutic approach of a high-output enterostomy in children.…”

mentioning

confidence: 99%

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Systematic review on management of high‐output enterostomy in children: An urgent call for evidence

Stoop,

van Bodegraven,

ten Haaft

et al. 2023

J. pediatr. gastroenterol. nutr.

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Objectives/BackgroundHigh‐output stoma is one of the most common major morbidities in young children with an enterostomy that could lead to intestinal failure. Management of high‐output enterostomy in children is mostly based on personal experience. This systematic review aims to clarify the evidence‐based therapeutic approach of high‐output enterostomy in children.MethodsA systematic review was performed using Pubmed, Embase (Ovid), and Cochrane Library to identify studies published until March 20, 2023, following the 2020 Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guideline. The study population comprised children (i.e., age <18 years) with high‐output enterostomy (i.e., jejuno‐, ileo‐, and/or colostomy), regardless of underlying aetiology. Interventions comprised any (non)pharmacological and/or surgical treatment. Interventions were compared with each other, placebos, and/or no interventions. Primary outcome was reduction of enterostomy output. Secondary outcomes were morbidity, mortality, quality of life, associated healthcare costs, and adverse events.ResultsThe literature search identified 4278 original articles of which 366 were screened on full text, revealing that none of the articles met the inclusion criteria.ConclusionThis first systematic review on management of high‐output enterostomy in children revealed that any evidence on the primary and secondary outcomes is lacking. There is an urgent need for evidence on conservative treatment strategies including fluid restrictions, dietary advices, oral rehydration solution, chyme re‐infusion, and pharmacological and surgical treatments of high‐output enterostomy in children, aiming to reduce the risk for short‐ and long‐term complications. Till more evidence is available, a systematic and multidisciplinary step‐up approach is needed. Therefore, a therapeutic work‐up is proposed that could guide the care.

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