[Intestinal stomas. Are they as simple as they seem?]

Area of Science:

• Pediatric Surgery
• Gastrointestinal Surgery
• Surgical Outcomes

Background:

• Enterostomies are common surgical procedures in pediatric patients.
• Assessing the morbidity and mortality associated with enterostomy formation and closure is essential for improving patient care.

Purpose of the Study:

• To evaluate the complications and mortality rates related to the creation and reversal of enterostomies in children.
• To identify potential risk factors associated with enterostomy-related complications.

Main Methods:

• A retrospective study was conducted on pediatric patients (<14 years) who underwent enterostomy between 2000 and 2014.
• Data collected included surgical techniques, underlying pathologies, stoma and general complications, and patient demographics.
• Analysis also focused on factors at the time of enterostomy closure, including nutritional markers and complication rates.

Main Results:

• 120 enterostomies were performed in 114 children, with colostomies being the most frequent type.
• Stoma-related complications occurred in 32.5% and general complications in 14.2% of cases.
• Loop enterostomies showed a significantly higher rate of complications requiring surgery (21.1%) compared to other techniques (p=0.007).
• Enterostomy closure had a complication rate of 14.6%, with higher rates for yeyunostomy and ileostomy closures (p=0.001).
• Lower hematocrit, hemoglobin, and albumin levels at closure were associated with increased complication risk (p<0.05).

Conclusions:

• Enterostomy formation and closure in pediatric patients are associated with significant morbidity.
• Loop enterostomy technique and suboptimal nutritional status (low albumin, hemoglobin, hematocrit) at closure are identified risk factors for complications.
• Further research into optimizing surgical techniques and nutritional support may reduce enterostomy-related complications.