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.
journal_name
Gastroenterol Res Practjournal_title
Gastroenterology research and practiceauthors
Sparks EA,Velazco CS,Fullerton BS,Fisher JG,Khan FA,Hall AM,Jaksic T,Rodriguez L,Modi BPdoi
10.1155/2017/7182429subject
Has Abstractpub_date
2017-01-01 00:00:00pages
7182429eissn
1687-6121issn
1687-630Xjournal_volume
2017pub_type
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