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Published on: December 1, 2012
Enterostomy complications in infancy and childhood
G Steinau1, K M Ruhl, H Hörnchen
1Department of Surgery, University Hospital of Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany.
Insights
Pediatric enterostomy formation and closure for severe gastrointestinal disorders present significant risks. This study highlights substantial morbidity and mortality associated with these life-saving procedures in infants and children.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Surgical Complications
Background:
- Severe gastrointestinal disorders in infants and children often necessitate enterostomy.
- Enterostomy is a critical treatment component for various pediatric diseases.
- This study retrospectively analyzes enterostomy outcomes in pediatric patients.
Purpose of the Study:
- To review the morbidity and mortality associated with enterostomy formation and closure in pediatric patients.
- To identify common indications and complication rates for pediatric enterostomies.
- To evaluate the safety and outcomes of enterostomy procedures in a young patient population.
Main Methods:
- Retrospective review of 68 enterostomies and 60 enterostomy closures in pediatric patients.
- Analysis included colostomies, jejunostomies, ileostomies, and Mikulicz procedures.
- Data collected over an 8-year period.
Main Results:
- Transverse colostomy was the most frequent procedure, primarily for intestinal obstruction and necrotizing enterocolitis.
- Over half of the patients were neonates (<1 month old) at the time of surgery.
- Overall complication rates were 38.2% for formation and 20% for closure, with a 7% mortality rate.
Conclusions:
- Enterostomy formation and closure in pediatric patients with severe underlying conditions are associated with considerable morbidity.
- While major complications like sepsis and fistula occurred in 10.3%, overall complication rates remain significant.
- Careful management is crucial to mitigate risks in pediatric enterostomy procedures.
Background:
A number of severe gastrointestinal disorders in infancy and childhood may require the formation of an enterostomy as a crucial part of the treatment of the disease itself. This study reviews our pediatric patients with regard to the morbidity and mortality of enterostomy formation and closure over an 8-year period.
Patients And Methods:
Sixty-eight enterostomies in infants and children and 60 consecutive enterostomy closures in retrospect are reported on. This includes colostomies, jejunostomies, ileostomies, and Mikulicz procedures.
Results:
In most instances, a transverse colostomy was performed. The most frequent indications were intestinal obstruction and necrotizing enterocolitis. More than half of the children were less than 1 month of age at the time of surgery. We observed an overall complication rate of 38.2% following enterostomy formation, with stoma prolapse being the most common, but faced major complications (such as sepsis, peritonitis, and enterocutaneous fistula) in only 10.3%. Complications after enterostomy closure were encountered in 20%. The overall mortality was 7%.
Conclusion:
Enterostomy formation and closure in the pediatric age group with severe underlying disease is still associated with substantial morbidity.
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