Investigation of the Optimal Timing of Ileostomy Closure in Very Low and Extremely Low Birth Weight Infants

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  • Yamamoto Yuki
    Department of Pediatric, Hepato-Biliary Pancreatic Surgery, Kitasato University School of Medicine
  • Tanaka Kiyoshi
    Department of Pediatric, Hepato-Biliary Pancreatic Surgery, Kitasato University School of Medicine
  • Deie Kyoichi
    Department of Pediatric, Hepato-Biliary Pancreatic Surgery, Kitasato University School of Medicine
  • Oiki Hironobu
    Department of Pediatric, Hepato-Biliary Pancreatic Surgery, Kitasato University School of Medicine

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  • 極・超低出生体重児の小腸ストーマ閉鎖術の至適時期に関する検討
  • ゴク ・ チョウテイシュッショウ タイジュウジ ノ ショウチョウ ストーマ ヘイサジュツ ノ シテキ ジキ ニ カンスル ケントウ

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<p>Purpose: Very low and extremely low birth weight infants may require an ileostomy for various diseases, but there are few studies on the optimal timing of ileostomy closure and the indicators are not clear. We investigated the optimal timing for ileostomy closure in our institution.</p><p>Methods: From January 2004 to December 2018, we performed ileostomy on 30 very low and extremely very low birth weight infants with necrotizing enterocolitis, focal intestinal perforation, or meconium-related ileus. We successfully performed ileostomy closure in 19 patients (63.3%) and assigned them into two groups, namely, those whose body weight at the time of stoma closure was equal to or more than 1,500 g (group A) and those less than 1,500 g (group B).</p><p>Results: There were no significant differences in birth weight and gestational age between the two groups. The patients weighed 2,100 g (1,610–3,640 g) in Group A and 1,339 g (890–1,460 g) in Group B when the ileostomy was closed. In group A, the number of days from ileostomy to the start of postoperative milk intake and the number of days from ileostomy to the day when the milk intake became 100 ml/kg/day were not significantly different between the two groups. The weight gain from the ileostomy to closure was significantly different, but that from ileostomy closure to discharge was not significantly different. Two patients in group A (18.2%) and one patient in group B (12.5%) had reoperation, and there was no significant difference in the reoperation rate. All 19 patients survived, with no intraoperative complications after ileostomy closure.</p><p>Conclusions: Stoma closure was considered safe even when the body weight is 1,500 g or less.</p>

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