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Timing and outcome of stoma closure in very low birth weight infants with surgical intestinal disorders

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Abstract

Purpose

Very low birth weight infants (VLBWIs) are at risk of surgical intestinal disorders including necrotizing enterocolitis (NEC), focal intestinal perforation (FIP), and meconium-related ileus (MRI). We conducted this study to verify whether the timing of stoma closure and that of enteral nutrition establishment after stoma closure in VLBWIs differ among the most common disorders.

Methods

A retrospective multicenter study was conducted at 11 institutes. We reviewed the timing of stoma closure and enteral nutrition establishment in VLBWIs who underwent stoma creation for intestinal disorders.

Results

We reviewed the medical records of 73 infants: 21 with NEC, 24 with FIP, and 25 with MRI. The postnatal age at stoma closure was 107 (28–359) days for NEC, 97 (25–302) days for FIP, and 101 (15–264) days for MRI (p = 0.793), and the postnatal age at establishment of enteral nutrition was 129 (42–381) days for NEC, 117 (41–325) days for FIP, and 128 (25–308) days for MRI (p = 0.855). The body weights at stoma closure were 1768 (620–3869) g for NEC, 1669 (1100–3040) g for FIP, and 1632 (940–3776) g (p = 0.614) for MRI. There were no significant differences among the three groups.

Conclusions

The present study revealed that the time and body weights at stoma closure and the postoperative restoration of bowel function in VLBWIs did not differ among the three diseases.

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Acknowledgements

This work was supported by a grant from the Ministry of Health, Labour and Welfare of Japan (Health and Labour Sciences Research Grants for Research on Intractable Diseases). We gratefully acknowledge the contributions of personnel from all the pediatric surgery and/or tertiary perinatal care centers for their assistance with data collection for this study.

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Authors and Affiliations

  1. Department of Surgery, Kanagawa Children’s Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama, 232-0066, Japan

    Kyoko Mochizuki

  2. Division of Neonatology, Center for Maternal-Neonatal Care, Nagoya University Hospital, Nagoya, Japan

    Masahiro Hayakawa

  3. Department of Pediatric Surgery, Shizuoka Children’s Hospital, Shizuoka, Japan

    Naoto Urushihara & Hiromu Miyake

  4. Department of Pediatric Surgery, Hyogo Prefectural Kobe Children’s Hospital, Kobe, Japan

    Akiko Yokoi

  5. Department of Neonatology, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan

    Jun Shiraishi

  6. Division of Neonatology, Center for Maternal-Fetal and Neonatal Medicine, National Center for Child Health and Development, Tokyo, Japan

    Hideshi Fujinaga

  7. Department of Pediatric Surgery, Nihon University School of Medicine, Tokyo, Japan

    Kensuke Ohashi

  8. Department of Pediatric Surgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Genshiro Esumi

  9. Department of Public Health, Osaka University Faculty of Medicine, Osaka, Japan

    Satoko Ohfuji

  10. Department of Pediatric Surgery, Miyagi Children’s Hospital, Sendai, Japan

    Shintaro Amae

  11. Department of Pediatric Surgery, Ibaraki Children’s Hospital, Mito, Japan

    Toshihiro Yanai

  12. Department of Pediatric Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan

    Taizo Furukawa

  13. Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Suita, Japan

    Yuko Tazuke & Hiroomi Okuyama

  14. Department of Pediatrics, Hyogo College of Medicine, Hyogo, Japan

    Kyoko Minagawa

Authors
  1. Kyoko Mochizuki
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  2. Masahiro Hayakawa
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  3. Naoto Urushihara
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  4. Hiromu Miyake
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  5. Akiko Yokoi
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  6. Jun Shiraishi
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  7. Hideshi Fujinaga
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  8. Kensuke Ohashi
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  9. Genshiro Esumi
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  10. Satoko Ohfuji
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  11. Shintaro Amae
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  12. Toshihiro Yanai
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  13. Taizo Furukawa
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  14. Yuko Tazuke
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  15. Kyoko Minagawa
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  16. Hiroomi Okuyama
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Corresponding author

Correspondence to Kyoko Mochizuki.

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Mochizuki, K., Hayakawa, M., Urushihara, N. et al. Timing and outcome of stoma closure in very low birth weight infants with surgical intestinal disorders. Surg Today 47, 1001–1006 (2017). https://doi.org/10.1007/s00595-017-1498-6

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  • DOI: https://doi.org/10.1007/s00595-017-1498-6

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