Evaluation of Postoperative Outcomes After Enterostomy Closure in Low Body Weight Infants: A Multi-Center Retrospective Analysis.

Autor:	Lee WG; Division of Pediatric Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.; Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA., O'Guinn ML; Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA., Keane OA; Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA., Krishna V; Division of Pediatric Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA., Mack SJ; Division of Pediatric Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA., Soliman A; Department of Neonatology, Miller Children's and Women's Hospital, Long Beach, CA, USA., Anselmo DM; Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.; Division of Pediatric Surgery, Miller Children's and Women's Hospital, Long Beach, CA, USA., Nguyen NX; Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA.; Division of Pediatric Surgery, Miller Children's and Women's Hospital, Long Beach, CA, USA., Gayer CP; Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA., Kim ES; Division of Pediatric Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA., Shue EH; Division of Pediatric Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.; Division of Pediatric Surgery, Miller Children's and Women's Hospital, Long Beach, CA, USA.
Jazyk:	angličtina
Zdroj:	The American surgeon [Am Surg] 2024 Oct; Vol. 90 (10), pp. 2534-2542. Date of Electronic Publication: 2024 Apr 22.
DOI:	10.1177/00031348241248788
Abstrakt:	Background: The minimum weight for enterostomy closure (EC) in infants remains debated with the current acceptable cut-off of >2 kg. As enterostomy-related complications or high enterostomy output (>30cc/kg/d) may prohibit a premature infant from reaching 2 kg, additional data is needed to evaluate the safety of EC in infants <2 kg. The objective of this study was to evaluate postoperative outcomes in low body weight (<2 kg) infants undergoing EC compared to larger infants. Methods: We performed a multi-center retrospective analysis from 1/1/2012-12/31/2022 of all infants (age <1 year) who were <4 kg at time of EC. Primary outcomes included postoperative complications and 30-day mortality. Non-parametric analysis was performed using the Kruskal-Wallis one-way analysis of variance and chi-square tests. Univariable logistic regression was performed to identify factors associated with postoperative complications. Results: Of 92 infants, 15 infants (16.3%) underwent EC at <2 kg, 16 (17.4%) at 2-2.49 kg, 31 (33.7%) at 2.5-2.99 kg, and 30 (32.6%) at ≥3 kg. Infants <2 kg at time of EC exhibited higher rates of hyperbilirubinemia ( P = .030), neurologic comorbidities ( P = .030), and high enterostomy output ( P = .041). There was no difference in postoperative complications ( P = .460) or 30-day mortality ( P = .460) between the <2 kg group and larger weight groups. Low body weight was not associated with an increased risk for developing a postoperative complication (OR: 1.001, 95% CI: 1.001-1.001; P = .032). Conclusion: Our findings suggest that EC in infants <2 kg may be safe with comparable postoperative outcomes to larger weight infants. Thus, the timing of EC should be based on the infant's physiologic status, in contrast to a predetermined minimum weight cut-off. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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