From colostomy creation to full enteral feeding in neonates with an anorectal malformation: evaluating the role of central venous access.

IF 1.6 4区医学 Q2 SURGERY

Frontiers in Surgery Pub Date : 2025-02-05 eCollection Date: 2025-01-01 DOI:10.3389/fsurg.2025.1524404

D Huijgen, I K Schokker-van Linschoten, H P Versteegh, C E J Sloots

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引用次数: 0

Abstract

Purpose: After creating a colostomy in newborns with anorectal malformations (ARMs), reaching full enteral feeding may take longer than expected, resulting in an unanticipated period of starvation. This retrospective cohort study aimed to evaluate the postoperative course regarding enteral feeding tolerance and the necessity for a central venous access device (CVAD) after colostomy formation in newborns with ARMs.

Methods: The files of neonates with ARMs who underwent colostomy formation between January 2014 and August 2023 were reviewed. The primary outcome was the postoperative tolerance of enteral feeding. Secondary outcomes were the need for a CVAD and CVAD-related complications.

Results: Thirty-four neonates with an ARM underwent colostomy formation. Enteral feeding was initiated on median postoperative day two (IQR 1-2). Full enteral feeding was reached on median postoperative day six (IQR 4-8). In nine neonates (26.5%), it took more than seven postoperative days to reach full enteral feeding, of whom seven (77.8%) had one or more comorbidities that could affect neonatal feeding tolerance. A CVAD was placed in 17 neonates (50%), of whom four (23.5%) needed additional general anesthesia for its placement. There were one or more CVAD-related complications in seven of 17 (41.2%) neonates, mainly involving suspicion of mild catheter-related infections.

Conclusions: The majority of neonates undergoing colostomy formation for an ARM require more than five days to achieve full enteral feeding. It is recommended to bridge this period of inadequate feeding with either fluids or parenteral nutrition by inserting a CVAD during colostomy formation, particularly for those with comorbidities affecting neonatal feeding tolerance.

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来源期刊

Frontiers in Surgery Medicine-Surgery

CiteScore

1.90

自引率

11.10%

发文量

1872

审稿时长

12 weeks

期刊介绍： Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.