J Korean Assoc Pediatr Surg.  2009 Jun;15(1):18-26.

Experience with Enterostomy Closure in Very Low Birth Weight Infants

Affiliations
  • 1Department of Pediatric Surgery, Seoul National University Children's Hospital, Seoul, Korea. leesc@plaza.snu.ac.kr

Abstract

The survival of Very Low Birth Weight (VLBW) infants has been improved with the advancement of neonatal intensive care. However, the incidence of accompanying gastrointestinal complications such as necrotizing enterocolitis has also been increasing. In intestinal perforation of the newborn, enterostomy with or without intestinal resection is a common practice, but there is no clear indication when to close the enterostomy. To determine the proper timing of enterostomy closure, the medical records of 12 VLBW infants who underwent enterostomy due to intestinal perforation between Jan. 2004 and Jul. 2007 were reviewed retrospectively. Enterostomy was closed when patients were weaned from ventilator, incubator-out and gaining adequate body weight. Pre-operative distal loop contrast radiographs were obtained to confirm the distal passage and complete removal of the contrast media within 24-hours. Until patients reached oral intake, all patients received central-alimentation. The mean gestational age of patients was 26(+2) wks (24(+1)~33(+0) wks) and the mean birth weight was 827 g (490~1450 g). The mean age and the mean body weight at the time of enterostomy formation were 15days (6~38 days) and 888 g (590~1870 g). The mean body weight gain was 18 g/day (14~25 g/day) with enterostomy. Enterostomy closure was performed on the average of 90days (30~123 days) after enterostomy formation. The mean age and the mean body weight were 105 days (43~136 days) and 2487 g (2290~2970 g) at the time of enterostomy closure. The mean body weight gain was 22 g/day after enterostomy closure. Major complications were not observed. In conclusion, the growth in VLBW infants having enterostomy was possible while supporting nutrition with central-alimentation and the enterostomy can be closed safely when the patient's body weights is more than 2.3 kg.

Keyword

Very low birth weight; Intestinal perforation; Enterostomy; Enterostomy closure

MeSH Terms

Birth Weight
Body Weight
Contrast Media
Enterocolitis, Necrotizing
Enterostomy
Gestational Age
Humans
Incidence
Infant
Infant, Newborn
Infant, Very Low Birth Weight
Intensive Care, Neonatal
Intestinal Perforation
Medical Records
Retrospective Studies
Ventilators, Mechanical
Contrast Media
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