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Ileostomy Complications in Infants less than 1500 grams - Frequent but Manageable
Simon Kargl1, Oliver Wagner2, Wolfgang Pumberger1
1Department of Pediatric Surgery, Kepler University Hospital, Linz.
Insights
Ileostomy complications are common in very low birth weight infants undergoing abdominal surgery. However, these stoma-related issues are manageable, with low mortality rates in this vulnerable population.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Gastrointestinal Surgery
Background:
- Abdominal emergency surgery in very low birth weight (VLBW) infants often necessitates ileostomy formation.
- VLBW infants experience a high incidence of stoma-related complications.
- This study retrospectively analyzes ileostomy complications in VLBW infants.
Purpose of the Study:
- To investigate the types and frequency of ileostomy-related problems in very low birth weight infants.
- To identify factors influencing stoma complications and outcomes.
- To assess the morbidity and mortality associated with ileostomies in this population.
Main Methods:
- Retrospective chart review of VLBW infants (<1500g) who underwent ileostomy formation between 2008 and 2014.
- Analysis of demographic data, indications for ileostomy, stoma complications, and short-term outcomes.
- Inclusion of 30 infants with various gastrointestinal conditions.
Main Results:
- Twenty out of thirty infants experienced stoma-related complications, including prolapse, obstruction, retraction, high output, skin excoriation, and ischemia.
- Complications did not correlate with the underlying disease (e.g., spontaneous intestinal perforation, meconium obstruction of prematurity, midgut volvulus).
- Stomal complications led to earlier stoma reversal (mean 62 days), with subsequent postoperative complications in three infants.
Conclusions:
- Ileostomy-related complications are frequent in very low birth weight infants.
- Despite high complication rates, mortality associated with ileostomies in VLBW infants is low.
- The morbidity associated with these stoma complications is generally manageable.
Background:
In very low birth weight infants abdominal emergency surgery may result in ileostomy formation. We observed a frequent stoma complications in these patients. This retrospective analysis put light on ileostomy-related problems and complications in very low birth weight (VLBW) infants.
Materials And Methods:
In a seven-year retrospective chart review (2008 - 2014) infants with ileostomy formation weighing less than 1500 grams at time of operation were identified and reviewed. Data analysis included demographic data, complications and short term outcomes.
Results:
Thirty patients were included. Ileostomy was formed for spontaneous intestinal perforation (SIP) (n=17), meconium obstruction of prematurity (MOP) (n=6), midgut volvulus (MV) (n=5), necrotizing enterocolitis (NEC) (n=1) and Hirschsprung's disease (HD) (n=1). Three patients died before ileostomy reversal was considered. In seven patients planned ileostomy reversal was done. Twenty infants had stoma related complications (stoma prolapse, prestomal obstruction, stoma retraction, high output stoma, peristomal skin excoriation, and stomal ischemia). Complications did not correlate with underlying diseases. Stomal complications necessitated earlier stoma reversal (mean 62 days). Postoperative complications after stoma reversal occurred in three children (wound dehiscence, adhesion ileus, anastomotic stricture).
Conclusions:
Although ileostomy related complications are frequent in very low birth weight infants, mortality is low. Morbidity is manageable.
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