Outcomes of Ostomy Location in Children: Placement of the Ostomy at the Umbilicus
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 sto...
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| Veröffentlicht in: | Journal of laparoendoscopic & advanced surgical techniques. Part A 2019-02, Vol.29 (2), p.243-247 |
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| container_title | Journal of laparoendoscopic & advanced surgical techniques. Part A |
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| creator | Sujka, Joseph Alemayehu, Hanna Benedict, Leo Andrew Sobrino, Justin A St Peter, Shawn D Fraser, Jason D |
| description | 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.
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 |
| doi_str_mv | 10.1089/lap.2018.0185 |
| format | Article |
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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 <.05 determined as significant. Results reported as means ± standard deviation and medians with interquartile ranges.
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.
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.</description><identifier>ISSN: 1092-6429</identifier><identifier>EISSN: 1557-9034</identifier><identifier>DOI: 10.1089/lap.2018.0185</identifier><identifier>PMID: 30222517</identifier><language>eng</language><publisher>United States</publisher><subject>Enteral Nutrition ; Enterocolitis, Necrotizing - surgery ; Female ; Hernia - etiology ; Humans ; Infant ; Infant, Newborn ; Male ; Ostomy - adverse effects ; Ostomy - methods ; Postoperative Complications - etiology ; Prolapse ; Retrospective Studies ; Surgical Stomas - adverse effects ; Surgical Stomas - physiology ; Time Factors ; Treatment Outcome ; Umbilicus - surgery</subject><ispartof>Journal of laparoendoscopic & advanced surgical techniques. Part A, 2019-02, Vol.29 (2), p.243-247</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c293t-38d9dee3de77f5b547101241aa9d2126c47fdeb2ed49166fb2232d32894695b83</citedby><cites>FETCH-LOGICAL-c293t-38d9dee3de77f5b547101241aa9d2126c47fdeb2ed49166fb2232d32894695b83</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30222517$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sujka, Joseph</creatorcontrib><creatorcontrib>Alemayehu, Hanna</creatorcontrib><creatorcontrib>Benedict, Leo Andrew</creatorcontrib><creatorcontrib>Sobrino, Justin A</creatorcontrib><creatorcontrib>St Peter, Shawn D</creatorcontrib><creatorcontrib>Fraser, Jason D</creatorcontrib><title>Outcomes of Ostomy Location in Children: Placement of the Ostomy at the Umbilicus</title><title>Journal of laparoendoscopic & advanced surgical techniques. Part A</title><addtitle>J Laparoendosc Adv Surg Tech A</addtitle><description>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.
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 <.05 determined as significant. Results reported as means ± standard deviation and medians with interquartile ranges.
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.
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.</description><subject>Enteral Nutrition</subject><subject>Enterocolitis, Necrotizing - surgery</subject><subject>Female</subject><subject>Hernia - etiology</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Ostomy - adverse effects</subject><subject>Ostomy - methods</subject><subject>Postoperative Complications - etiology</subject><subject>Prolapse</subject><subject>Retrospective Studies</subject><subject>Surgical Stomas - adverse effects</subject><subject>Surgical Stomas - physiology</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Umbilicus - surgery</subject><issn>1092-6429</issn><issn>1557-9034</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kE1LxDAQhoMo7rp69Co9eumaTNKPeJPFLyisgnsOaTJlK22zNulh_72tu-vAMDPw8MI8hNwyumQ0lw-N3i2Bsnw5dnJG5ixJslhSLs7HnUqIUwFyRq68_6ZjSS4uyYxTAEhYNief6yEY16KPXBWtfXDtPiqc0aF2XVR30WpbN7bH7jH6aLTBFrswkWGLJ1qHv2vTlnVTm8Ffk4tKNx5vjnNBNi_PX6u3uFi_vq-eitiA5CHmuZUWkVvMsiopE5ExykAwraUFBqkRWWWxBLRCsjStSgAOlkMuRSqTMucLcn_I3fXuZ0AfVFt7g02jO3SDVzB-z3lKmRzR-ICa3nnfY6V2fd3qfq8YVZNFNVpUk0U1WRz5u2P0ULZo_-mTNv4Lj8Jsdw</recordid><startdate>201902</startdate><enddate>201902</enddate><creator>Sujka, Joseph</creator><creator>Alemayehu, Hanna</creator><creator>Benedict, Leo Andrew</creator><creator>Sobrino, Justin A</creator><creator>St Peter, Shawn D</creator><creator>Fraser, Jason D</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201902</creationdate><title>Outcomes of Ostomy Location in Children: Placement of the Ostomy at the Umbilicus</title><author>Sujka, Joseph ; Alemayehu, Hanna ; Benedict, Leo Andrew ; Sobrino, Justin A ; St Peter, Shawn D ; Fraser, Jason D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c293t-38d9dee3de77f5b547101241aa9d2126c47fdeb2ed49166fb2232d32894695b83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Enteral Nutrition</topic><topic>Enterocolitis, Necrotizing - surgery</topic><topic>Female</topic><topic>Hernia - etiology</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Ostomy - adverse effects</topic><topic>Ostomy - methods</topic><topic>Postoperative Complications - etiology</topic><topic>Prolapse</topic><topic>Retrospective Studies</topic><topic>Surgical Stomas - adverse effects</topic><topic>Surgical Stomas - physiology</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Umbilicus - surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sujka, Joseph</creatorcontrib><creatorcontrib>Alemayehu, Hanna</creatorcontrib><creatorcontrib>Benedict, Leo Andrew</creatorcontrib><creatorcontrib>Sobrino, Justin A</creatorcontrib><creatorcontrib>St Peter, Shawn D</creatorcontrib><creatorcontrib>Fraser, Jason D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of laparoendoscopic & advanced surgical techniques. Part A</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sujka, Joseph</au><au>Alemayehu, Hanna</au><au>Benedict, Leo Andrew</au><au>Sobrino, Justin A</au><au>St Peter, Shawn D</au><au>Fraser, Jason D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of Ostomy Location in Children: Placement of the Ostomy at the Umbilicus</atitle><jtitle>Journal of laparoendoscopic & advanced surgical techniques. Part A</jtitle><addtitle>J Laparoendosc Adv Surg Tech A</addtitle><date>2019-02</date><risdate>2019</risdate><volume>29</volume><issue>2</issue><spage>243</spage><epage>247</epage><pages>243-247</pages><issn>1092-6429</issn><eissn>1557-9034</eissn><abstract>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.
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 <.05 determined as significant. Results reported as means ± standard deviation and medians with interquartile ranges.
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.
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.</abstract><cop>United States</cop><pmid>30222517</pmid><doi>10.1089/lap.2018.0185</doi><tpages>5</tpages></addata></record> |
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| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Enteral Nutrition Enterocolitis, Necrotizing - surgery Female Hernia - etiology Humans Infant Infant, Newborn Male Ostomy - adverse effects Ostomy - methods Postoperative Complications - etiology Prolapse Retrospective Studies Surgical Stomas - adverse effects Surgical Stomas - physiology Time Factors Treatment Outcome Umbilicus - surgery |
| title | Outcomes of Ostomy Location in Children: Placement of the Ostomy at the Umbilicus |
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