Ileostomy Prolapse in Children with Intestinal Dysmotility
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...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2017-01-01
|
| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2017/7182429 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832549849999867904 |
|---|---|
| author | Eric A. Sparks Cristine S. Velazco Brenna S. Fullerton Jeremy G. Fisher Faraz A. Khan Amber M. Hall Tom Jaksic Leonel Rodriguez Biren P. Modi |
| author_facet | Eric A. Sparks Cristine S. Velazco Brenna S. Fullerton Jeremy G. Fisher Faraz A. Khan Amber M. Hall Tom Jaksic Leonel Rodriguez Biren P. Modi |
| author_sort | Eric A. Sparks |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-47223825f89b428bbb886b4896b2550a |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Gastroenterology Research and Practice |
| spelling | doaj-art-47223825f89b428bbb886b4896b2550a2025-02-03T06:08:23ZengWileyGastroenterology Research and Practice1687-61211687-630X2017-01-01201710.1155/2017/71824297182429Ileostomy Prolapse in Children with Intestinal DysmotilityEric A. Sparks0Cristine S. Velazco1Brenna S. Fullerton2Jeremy G. Fisher3Faraz A. Khan4Amber M. Hall5Tom Jaksic6Leonel Rodriguez7Biren P. Modi8Center for Advanced Intestinal Rehabilitation, Boston Children’s Hospital, Boston, MA, USACenter for Advanced Intestinal Rehabilitation, Boston Children’s Hospital, Boston, MA, USACenter for Advanced Intestinal Rehabilitation, Boston Children’s Hospital, Boston, MA, USACenter for Advanced Intestinal Rehabilitation, Boston Children’s Hospital, Boston, MA, USACenter for Advanced Intestinal Rehabilitation, Boston Children’s Hospital, Boston, MA, USADepartment of Surgery, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USACenter for Advanced Intestinal Rehabilitation, Boston Children’s Hospital, Boston, MA, USADepartment of Medicine, Division of Gastroenterology, Center for Gastrointestinal Motility and Functional Disorders, Boston Children’s Hospital, Boston, MA, USACenter for Advanced Intestinal Rehabilitation, Boston Children’s Hospital, Boston, MA, USABackground. 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.http://dx.doi.org/10.1155/2017/7182429 |
| spellingShingle | Eric A. Sparks Cristine S. Velazco Brenna S. Fullerton Jeremy G. Fisher Faraz A. Khan Amber M. Hall Tom Jaksic Leonel Rodriguez Biren P. Modi Ileostomy Prolapse in Children with Intestinal Dysmotility Gastroenterology Research and Practice |
| title | Ileostomy Prolapse in Children with Intestinal Dysmotility |
| title_full | Ileostomy Prolapse in Children with Intestinal Dysmotility |
| title_fullStr | Ileostomy Prolapse in Children with Intestinal Dysmotility |
| title_full_unstemmed | Ileostomy Prolapse in Children with Intestinal Dysmotility |
| title_short | Ileostomy Prolapse in Children with Intestinal Dysmotility |
| title_sort | ileostomy prolapse in children with intestinal dysmotility |
| url | http://dx.doi.org/10.1155/2017/7182429 |
| work_keys_str_mv | AT ericasparks ileostomyprolapseinchildrenwithintestinaldysmotility AT cristinesvelazco ileostomyprolapseinchildrenwithintestinaldysmotility AT brennasfullerton ileostomyprolapseinchildrenwithintestinaldysmotility AT jeremygfisher ileostomyprolapseinchildrenwithintestinaldysmotility AT farazakhan ileostomyprolapseinchildrenwithintestinaldysmotility AT ambermhall ileostomyprolapseinchildrenwithintestinaldysmotility AT tomjaksic ileostomyprolapseinchildrenwithintestinaldysmotility AT leonelrodriguez ileostomyprolapseinchildrenwithintestinaldysmotility AT birenpmodi ileostomyprolapseinchildrenwithintestinaldysmotility |