Influence of weight at enterostomy reversal on surgical outcomes in infants after emergent neonatal stoma creation

Talbot, Lindsay J.; Sinyard, Robert D.; Rialon, Kristy L.; Englum, Brian R.; Tracy, Elizabeth T.; Rice, Henry E.; Adibe, Obinna O.

doi:10.1016/j.jpedsurg.2016.10.015

Cited by 23 publications

(18 citation statements)

References 18 publications

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“…Although treatment-related factors were investigated most frequently, factors concerning the neonatal period, such as mode of delivery and breast feeding, and other patient-related factors, such as exposure to smoking in the first years of the child's life, may also play an important role. The effects of these factors on the child's general health or immune status [12][13][14] may influence the risk of postoperative complications. Some factors were studied in association with surgical complications before [12,14], but never for patients with hypospadias.…”

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confidence: 99%

“…The effects of these factors on the child's general health or immune status [12][13][14] may influence the risk of postoperative complications. Some factors were studied in association with surgical complications before [12,14], but never for patients with hypospadias. The aim of this study was to develop and internally validate a prediction model using treatment-and patient-related factors to predict the risk of postoperative complications within one year after primary hypospadias correction.…”

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confidence: 99%

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Development of a prediction model for postoperative complications after primary hypospadias correction

Dokter¹,

Zanden²,

Laumer³

et al. 2020

Journal of Pediatric Surgery

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To develop a prediction model for postoperative complications after primary one-stage hypospadias correction to improve preoperative parental counseling. Materials and methods: In this retrospective cohort study, data were collected from 356 patients with anterior or middle hypospadias who had a one-stage hypospadias correction from 2003 onwards. Potential treatment-and patient-related factors were selected and used to develop a prediction model for postoperative complications within one year (wound-related complications, urinary tract infections, fistulas, stenosis, and prepuce-related complications). Multivariable logistic regression analysis with stepwise backward selection and a p-value of 0.20 was used to select the final model, which was internally validated using the bootstrap procedure. Results: Complications within one year postoperatively occurred in 66 patients (19%), of which 13% and 37% were seen in anterior and middle type of hypospadias, respectively. Hypospadias phenotype, surgical technique, chordectomy, and surgeon's experience were included in the final prediction model, whereas none of the patientrelated factors were. The final model had a good discriminative ability (bias corrected C statistic 0.70) and calibration. Conclusion: Using easily obtainable information, this model showed good accuracy in predicting complications within one year after hypospadias surgery. It is a first step towards individualized risk prediction of postoperative complications for anterior and middle hypospadias and can assist in preoperative parental counseling.

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confidence: 99%

mentioning

confidence: 99%

Development of a prediction model for postoperative complications after primary hypospadias correction

Dokter¹,

Zanden²,

Laumer³

et al. 2020

Journal of Pediatric Surgery

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“…Although many studies have examined EC timing, it is still difficult to make a definite conclusion about when to perform EC. One report analyzed 89 patients who were <6 months of age at the time of EC 13 . The patients were stratified into four groups based on their Bwt at EC (<2 kg, 2–2.5 kg, 2.5–3.5 kg, and ≥3.5 kg).…”

Section: Discussionmentioning

confidence: 99%

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

Yang

Han

Youn

et al. 2018

Sci Rep

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There are few reports on enterostomy closure (EC) timing for acute abdomen in extremely low birth weight (ELBW) patients. We retrospectively reviewed ELBW patients who underwent enterostomy formation (EF) and subsequent EC. We investigated baseline characteristics, surgical outcomes, and follow-up data of 55 patients and analyzed optimal timing by age at EC, enterostomy duration, and body weight (Bwt) at EC. The minimum p-value approach (MPA) using the Chi-squared test was used to determine each cut-off value. Mean gestational age was 25+3 weeks, while mean age and Bwt at EF were 10 days and 660 g. Enterostomy duration and Bwt at EC were 102 days and 2400 g. Fourteen surgical complications were related to EC. The MPA identified a cut-off of 2100 g (p = 0.039) at EC but no significant cut-off age or enterostomy duration. The 18 patients <2100 g had more enterostomy-related problems at EC than the >2100 g group (66.7% vs 10.8%, p < 0.001). No other characteristics were significantly different. Operation time, ventilator period, hospital stay, parenteral nutrition duration, and full feeding day were significantly longer in <2100 g patients. Follow-up Bwt did not differ (11.55 kg vs 13.95 kg, p = 0.324). Our findings suggest EC can be safely performed when Bwt is over 2100 g.

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“…12,13 Metabolic complications relate to high enterostomy output, malnutrition, electrolyte imbalances, and vitamin losses leading to intestinal failure, failure to thrive, and possible long-term neurodevelopmental impairment. 14,15 Early stoma closure or stoma revision is needed in case of mechanical enterostomy complications and high enterostomy output. Early stoma reversal may be an option as it is shown not be related to increased perioperative complications.…”

Section: Gastrointestinal Complications Complications Related To Surgmentioning

confidence: 99%

“…Early stoma reversal may be an option as it is shown not be related to increased perioperative complications. 15,16 In infants receiving operation for NEC, the complications due to enterostomy and the need for another operation to restore continuity have prompted several surgeons to opt for primary anastomosis after bowel resection as the operative strategy of choice. 11,17,18 After primary anastomosis for surgical NEC, anastomotic leak or stricture is seen in 2 to 8% of patients.…”

Section: Gastrointestinal Complications Complications Related To Surgmentioning

confidence: 99%

Perioperative Complications Following Surgery for Necrotizing Enterocolitis

2018

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Necrotizing enterocolitis (NEC) is a devastating condition that mainly affects premature infants. Advanced cases of NEC require surgical treatment, which in up to 70% of infants is associated with significant perioperative morbidity including anastomosis- or enterostomy-related complications, sepsis, peritonitis, and wound infections. Moreover, the perioperative complications may compromise the long-term gastrointestinal and neurodevelopmental outcome of patients requiring surgery for NEC.

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Influence of weight at enterostomy reversal on surgical outcomes in infants after emergent neonatal stoma creation

Cited by 23 publications

References 18 publications

Development of a prediction model for postoperative complications after primary hypospadias correction

Development of a prediction model for postoperative complications after primary hypospadias correction

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

Perioperative Complications Following Surgery for Necrotizing Enterocolitis

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