Ileostomy Prolapse in Children with Intestinal Dysmotility
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Sparks, Eric A.
Velazco, Cristine S.
Fisher, Jeremy G.
Khan, Faraz A.
Hall, Amber M.
Rodriguez, Leonel
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https://doi.org/10.1155/2017/7182429Metadata
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Sparks, Eric A., Cristine S. Velazco, Brenna S. Fullerton, Jeremy G. Fisher, Faraz A. Khan, Amber M. Hall, Tom Jaksic, Leonel Rodriguez, and Biren P. Modi. 2017. “Ileostomy Prolapse in Children with Intestinal Dysmotility.” Gastroenterology Research and Practice 2017 (1): 7182429. doi:10.1155/2017/7182429. http://dx.doi.org/10.1155/2017/7182429.Abstract
Background: A relationship between intestinal motility and ileostomy prolapse has been suggested but not demonstrated objectively. Aims This study evaluated the association between ileostomy prolapse and intestinal dysmotility in children. Methods: IRB-approved retrospective review of 163 patients with ileostomies (1998–2014) at a single institution. Patients were categorized as having clinical dysmotility as a primary diagnosis (n = 33), clinically suspected dysmotility based on underlying diagnosis (n = 60), or intestinal dysmotility unlikely (n = 70) at the time of ileostomy present. Intestinal manometry was categorized as normal (n = 13) or abnormal (n = 10). Primary outcome was pathologic stoma prolapse. Multivariate analysis using a logistic regression model and log-rank test to compare stoma prolapse rates over time between motility groups were used. Results: Clinical diagnosis of dysmotility (p ≤ 0.001) and manometric findings of dysmotility (p = 0.024) were independently associated with stoma prolapse. Clinical dysmotility correlated with manometric findings (κ = 0.53). Prolapse occurred in 42% of patients with dysmotility, 34% of patients with suspected dysmotility, and 24% of patients with normal motility. One-year prolapse-free stoma “survival” was 45% for dysmotility, 72% for suspected dysmotility, and 85% for intestinal dysmotility unlikely groups (p = 0.006). Conclusions: Children with intestinal dysmotility are at great risk for stoma prolapse. Intestinal manometry could help identify these patients preoperatively.Other Sources
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624168/pdf/Terms of Use
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