Adv Pediatr Surg.  2023 Jun;29(1):17-23. 10.13029/aps.2023.29.1.17.

Enterostomy Related Complications in Very Low Birth Weight Infants: A Single-Center Experience

• Cho YJ
• Kwon H
• Kim SC
• Kim DY
• Namgoong JM

• KMID: 2551508
• DOI: http://doi.org/10.13029/aps.2023.29.1.17

Abstract

Purpose
Enterostomies in premature infants are associated with a high incidence of complications. This study analyzed the factors associated with complications in very low birth weight (VLBW) infants who underwent enterostomy.
Methods
VLBW infants with preoperative weights below 1,500 g who underwent enterostomy between January 2003 and May 2018 were analyzed. The gestational age, corrected age, birth weight, weight at the time of surgery, surgery location, causative disease, laboratory findings, and complications were also analyzed.
Results
A total of 61 cases were included, consisting of 16 cases with stomal complications (26.2%); 12 prolapses (19.7%), 3 cases of parastomal hernias (4.9%), and 1 case of prestomal obstruction (1.6%). Premature infants born before 28 weeks gestation had approximately a three-fold increase in complications, albeit without statistical significance (p=0.11). These infants also had high incidences of bedside operations (p=0.003). Differences in surgical sites did not significantly impact the complication rate. Seven patients (11.5%) underwent reoperation for their complications. Twelve patients had prolapses, and six of these patients (50%) underwent reoperative surgeries. The mortality rate among the included patients was 24.6% (15 patients). These deaths were not associated with enterostomy, and seven deaths (46.7%) were attributed to neonatal sepsis and necrotizing enterocolitis.
Conclusion
VLBW infants, particularly those born before 28 weeks of gestation, typically have stomal complications. Therefore, surgical techniques should be aimed at minimizing stomal complications when operating on VLBW patients.

Keyword

Enterostomy; Very low birth weight; Complications