Systematic review on management of high-output enterostomy in children: An urgent call for evidence.

Autor: Stoop TF; Amsterdam UMC, Location University of Amsterdam, Pediatric Surgical Center of Amsterdam, Emma Children's Hospital, Department of Pediatric Surgery, Amsterdam, The Netherlands.; Amsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Amsterdam, The Netherlands.; Division of Surgical Oncology, Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA., van Bodegraven EA; Amsterdam UMC, Location University of Amsterdam, Pediatric Surgical Center of Amsterdam, Emma Children's Hospital, Department of Pediatric Surgery, Amsterdam, The Netherlands.; Amsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Amsterdam, The Netherlands., Ten Haaft BHEA; Amsterdam UMC, Location University of Amsterdam, Pediatric Surgical Center of Amsterdam, Emma Children's Hospital, Department of Pediatric Surgery, Amsterdam, The Netherlands.; Amsterdam UMC, Location University of Amsterdam, Department of Surgery, Amsterdam, The Netherlands.; Cancer Center Amsterdam, Amsterdam, The Netherlands., van Etten-Jamaludin FS; Medical Information Specialist, Amsterdam UMC, Location University of Amsterdam, Amsterdam, The Netherlands., van Zundert SMC; Amsterdam UMC, Location University of Amsterdam, Department of Nutrition and Dietetics, Amsterdam, The Netherlands., Lambe C; Department of Pediatric Gastroenterology, Hepatology and Nutrition, Intestinal Failure Rehabilitation Center, Necker-Enfants Malades Hospital, APHP, Paris, France., Tabbers MM; Department of Pediatric Gastroenterology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Gorter RR; Amsterdam UMC, Location University of Amsterdam, Pediatric Surgical Center of Amsterdam, Emma Children's Hospital, Department of Pediatric Surgery, Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Journal of pediatric gastroenterology and nutrition [J Pediatr Gastroenterol Nutr] 2024 Feb; Vol. 78 (2), pp. 188-196. Date of Electronic Publication: 2023 Dec 27.
DOI: 10.1002/jpn3.12043
Abstrakt: Objectives/background: High-output stoma is one of the most common major morbidities in young children with an enterostomy that could lead to intestinal failure. Management of high-output enterostomy in children is mostly based on personal experience. This systematic review aims to clarify the evidence-based therapeutic approach of high-output enterostomy in children.
Methods: A systematic review was performed using Pubmed, Embase (Ovid), and Cochrane Library to identify studies published until March 20, 2023, following the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. The study population comprised children (i.e., age <18 years) with high-output enterostomy (i.e., jejuno-, ileo-, and/or colostomy), regardless of underlying aetiology. Interventions comprised any (non)pharmacological and/or surgical treatment. Interventions were compared with each other, placebos, and/or no interventions. Primary outcome was reduction of enterostomy output. Secondary outcomes were morbidity, mortality, quality of life, associated healthcare costs, and adverse events.
Results: The literature search identified 4278 original articles of which 366 were screened on full text, revealing that none of the articles met the inclusion criteria.
Conclusion: This first systematic review on management of high-output enterostomy in children revealed that any evidence on the primary and secondary outcomes is lacking. There is an urgent need for evidence on conservative treatment strategies including fluid restrictions, dietary advices, oral rehydration solution, chyme re-infusion, and pharmacological and surgical treatments of high-output enterostomy in children, aiming to reduce the risk for short- and long-term complications. Till more evidence is available, a systematic and multidisciplinary step-up approach is needed. Therefore, a therapeutic work-up is proposed that could guide the care.
(© 2023 The Authors. Journal of Pediatric Gastroenterology and Nutrition published by Wiley Periodicals LLC on behalf of European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.)
Databáze: MEDLINE
Externí odkaz: