Title

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

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