The effect of early and late stoma closure on nutritional outcome at 12 months of age in children with meconium ileus secondary to cystic fibrosis
| Autor: | S.E. Kenny, Kevin W Southern, D.M. Chong, L. Heaf |
|---|---|
| Jazyk: | angličtina |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty business.industry Meconium Ileus medicine.disease digestive system Cystic fibrosis digestive system diseases Surgery Bowel obstruction Stoma closure surgical procedures operative Stoma (medicine) Pediatrics Perinatology and Child Health medicine Weight centile Case note Pediatrics Perinatology and Child Health medicine.symptom business Weight gain |
| Zdroj: | Journal of Cystic Fibrosis. :S95 |
| ISSN: | 1569-1993 |
| DOI: | 10.1016/S1569-1993(08)60361-6 |
| Popis: | Introduction: A small but significant number of infants with cystic fibrosis (CF) require neonatal surgery to relieve bowel obstruction from meconium ileus (MI). This often results in stoma formation to encourage feeding, weight gain and recycling of stoma output. We have undertaken a retrospective review to determine the impact of time to stoma closure on nutritional status at 12 months of age. Methods: A retrospective case note review of patients currently attending the Royal Liverpool Children’s Hospital Regional CF Clinic (n, 282). We recorded duration of stoma and weight centile at three stages: stoma formation, closure, and at 12 month review. Complications of stoma and hospital stay were also noted. Stoma duration less than 8 weeks was classed as early closure (E) and more than 8 weeks as late (L). The change in weight centile at 12 month review was used as a measure of nutritional outcome. Results: 48 children presented with MI (1990–2007); data were available for 26 included in the study. The early and late closure groups consisted of 19 (median time to closure 5 weeks) and 7 patients (13 weeks) respectively. 63% of the early closure group showed an increased weight centile at 12 months compared to 57% of the late group. Stoma duration did not affect post-closure hospital stay. Late stoma closure was associated with increased cases of post closure obstruction (E vs. L; 15.8% vs. 57.1%). Conclusion: This review suggests that the time to stoma closure does not impact significantly on subsequent nutritional status. More studies are needed to determine the optimal post-operative management in this challenging group of children. |
| Databáze: | OpenAIRE |
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