Outcomes of Ostomy Location in Children: Placement of the Ostomy at the Umbilicus.
Document Type
Article
Publication Date
2-1-2019
Identifier
DOI: 10.1089/lap.2018.0185
Abstract
PURPOSE: Neonatal exploratory laparotomies are often performed with a transumbilical incision in our institution, so umbilical ostomy placement has become more common. The purpose of our study is to evaluate the outcomes of neonates with ostomy placement at the umbilicus in comparison to more traditional stoma locations.
MATERIAL AND METHODS: Retrospective study of neonates that underwent an exploratory laparotomy with ostomy creation between January 2010 and September 2015. Demographics, presentation, feedings, ostomy position, postoperative complications, and outcomes were collected. Comparative analysis was performed in STATA with P-value
RESULTS: Fifty-four children were included, 37% (n = 20) had stomas at the umbilicus. Most common other stoma location was the right lower quadrant (63%, n = 34). Necrotizing enterocolitis (NEC) was the most common indication for surgery in both groups. Days to stoma output were similar between the two groups, [3 (1, 6) versus 2 (1, 5), P = .96]. Days to initiation of feeds were delayed in the umbilical ostomy group [15 (9.5, 23.5) versus 6 (4, 10), P = .02]. Comparing only NEC patients, initiation of feeds was similar [22 (14, 56) versus 15.5 (8, 43), P = .73]. Umbilical ostomies had an increase in prolapse/peristomal hernias (7 versus 3, P = .01), but no patients required operative revision.
CONCLUSION: Umbilical ostomies had similar time to stoma function compared to other sites, but a delay in initiation of oral feeds likely secondary to a higher percentage of patients with NEC.
Journal Title
Journal of laparoendoscopic & advanced surgical techniques. Part A
Volume
29
Issue
2
First Page
243
Last Page
247
MeSH Keywords
Enteral Nutrition; Enterocolitis, Necrotizing; Female; Hernia; Humans; Infant; Infant, Newborn; Male; Ostomy; Postoperative Complications; Prolapse; Retrospective Studies; Surgical Stomas; Time Factors; Treatment Outcome; Umbilicus
Keywords
exploratory laparotomy; necrotizing enterocolitis; neonate; stoma; umbilical ostomy; NEC
Recommended Citation
Sujka J, Alemayehu H, Benedict LA, Sobrino JA, St Peter SD, Fraser JD. Outcomes of Ostomy Location in Children: Placement of the Ostomy at the Umbilicus. J Laparoendosc Adv Surg Tech A. 2019;29(2):243-247. doi:10.1089/lap.2018.0185
