Up to 50% of infants with NEC require surgical intervention, which generally consists of exploration of the abdomen, bowel resection, and stoma formation. The bowel used for formation of the stoma is frequently of marginal viability, and the infants are usually systemically ill during this emergent procedure.
Aguayo et al [Journal of Surgical Research (2009) 157(2):275-8] performed a retrospective study to assess the factors associated with an increased risk of stomal complications in infants undergoing operative intervention for NEC. The authors noted a 43% rate of stomal complications (5% retraction, 5% Skin excoriation, 8% prolapse, 7% necrosis, 15% stricture, 3% parastomal hernias). They also noted a significant increase in risk of complications with lower gestational age and lower preoperative weight.
Intestinal stomas, although potentially life saving, have a surprisingly high rate of complications. They should be created with meticulous technique in order to help decrease the risk of morbid complications and need for revision.
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