Postoperative complications and risk factors of neonatal enterostomy
Gao Yang, Zhao Baohong , Ren Hongxia
1. Department of Pediatrics, Shanxi Medical University, Shanxi,
Taiyuan 030001, China; 2. Department of Neonatal Surgery, Children’s Hospital of Shanxi, Shanxi, Taiyuan
030013, China)
Abstract: 【Abstract】 Objective To explore the clinical characteristics of neonatal enterostomy and risk factors of fistula-related complications. Method From July 2016 to June 2021, 104 neonates who underwent enterostomy and fistula closure several months later in the Department of Neonatal Surgery, Children's Hospital of Shanxi were included in the study. According to whether ?stula-related complications occurred after enterostomy, they were divided into complication group (n=42) and non-complication group (n=62). The differences of clinical indicators between the two groups were compared, and the risk factors of fistula-related complications after enterostomy were analyzed. The χ2test, Mann-Whitney U test and multivariate Logistic regression were used for statistics. Result Of the 104 patients, 42 cases (40.4%) had complications. Complications included high-?ow diarrhea in 24 cases (23.1%), wound infection in 10 cases (9.6%), incomplete intestinal obstruction in 9 cases (8.7%), intestinal prolapse in 5 cases (4.8%), intestinal incarceration in 4 cases (3.9%) and intestinal retraction in 1 case (1.0%). The results of univariate analysis showed that the incidence of complications in intestinal resection group was higher than that in intestinal nonresectiongroup [59.1% (26/44) vs 26.7% (16/60), χ2=11.085, P=0.001], that in jejunostomy group was higher than that in colostomy group [52.1% (37/71) vs 15.2% (5/33), χ2 =12.784, P<0.001], that in infectious disease group was higher than that in non-infectious disease group [53.7 % (22/41) vs 31.7 % (20/63), χ2=4.953, P=0.026], and the length of proximal small intestine in < 80 cm group was higher than that in ≥ 80 cm group [100.0% (13/13) vs 31.9 % (29/91), χ2=21.932, P<0.001]. The duration of postoperative parenteral nutrition in the complication group was longer than that in the non-complication group [7 (0, 11) vs 0 (0, 9) d, Z= –2.119, P=0.034], and the difference was statistically signi?cant. Multivariate Logistic regression analysis showed that infectious diseases (OR=3.030, P=0.023 ) and jejunostomy (OR=3.135, P=0.046) were independent risk factors for complications after neonatal enterostomy. Conclusion Complications are common after neonatal enterostomy. Clinical intervention for risk factors such as primary infectious diseases and jejunostomy can help reduce the incidence of postoperative complications and improve prognosis.
2022, Vol. 10 
