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The Optimal Timing of Enterostomy Closure in Extremely Low Birth Weight Patients for Acute Abdomen

Hee-Beom Yang1, Ji-Won Han1, Joong Kee Youn1

  • 1Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, Korea.

Scientific Reports
|October 26, 2018
PubMed

Insights

Enterostomy closure (EC) in extremely low birth weight (ELBW) infants is safest after reaching 2100 grams. Infants under this weight experienced more complications and longer hospital stays, highlighting the importance of weight-based timing for EC in ELBW patients.

Area of Science:

  • Neonatal surgery
  • Pediatric surgery
  • Gastrointestinal surgery

Background:

  • Enterostomy closure (EC) timing in extremely low birth weight (ELBW) neonates with acute abdomen is not well-established.
  • Limited data exists regarding optimal surgical timing for EC in this vulnerable population.

Purpose of the Study:

  • To investigate the optimal timing for enterostomy closure (EC) in extremely low birth weight (ELBW) patients.
  • To analyze the impact of age, enterostomy duration, and body weight at EC on surgical outcomes.

Main Methods:

  • Retrospective review of 55 ELBW patients who underwent enterostomy formation (EF) and subsequent EC.
  • Utilized the minimum p-value approach (MPA) with Chi-squared tests to determine optimal cut-off values for EC timing.
  • Compared outcomes between groups based on identified weight cut-offs.

Main Results:

  • A body weight cut-off of 2100 grams at EC was identified as significant (p=0.039).
  • Patients weighing <2100g at EC had significantly higher rates of enterostomy-related complications (66.7% vs 10.8%, p<0.001).
  • Shorter operation time, ventilator duration, hospital stay, and parenteral nutrition were observed in infants >2100g at EC.

Conclusions:

  • Enterostomy closure in ELBW infants is recommended when their body weight exceeds 2100 grams.
  • Weight-based timing for EC significantly impacts complication rates and recovery in ELBW patients.
  • Further research may refine EC timing protocols for improved neonatal surgical outcomes.

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