Reanastomosis is associated with higher chance of enteral autonomy in children with short bowel syndrome and stoma: Experience over two decades in a Multidisciplinary Intestinal Rehabilitation Unit [Oral presentation]

Abstract

<p>Aim: Short bowel syndrome (SBS) is a serious form of organ failure in children. A substantial population of SBS children have stoma and potentially subject them to higher risk of complications. Controversies existed on the timing and outcomes of reanastomosis in this subset of patients. This study aimed to evaluate the outcome of children with SBS and stoma in a tertiary paediatric centre.</p><p>Methods: A retrospective single-centre analysis of all paediatric patients with clinical diagnosis of SBS with stoma between 2001 and 2022 was performed. Clinical outcomes and their predictors were extracted and analysed.</p><p>Results: A total of 64 children with SBS were managed during the study period. 50 (76.9%) of them had a stoma. Thirty-eight (76%) had extensive necrotizing enterocolitis. The median bowel length was 45cm (IQR 20 – 60), and 19.5% (IQR 9.4 – 30) of the expected length for age. Over a mean of 8.6 years of follow up, survival was 47/50 (94%) and 40 (80%) weaned off PN. 40/50 (80%) received reanastomosis at 4.2+/-9.3 months. Reanastomosis is associated with significantly higher chance of weaning PN (OR 4.0, p = 0.008), less IFALD (OR 0.244, p = 0.008) and lower mortality (OR 0.7, p <0.001). Earlier closure of stoma was associated with quicker achievement of enteral autonomy (<em>r </em>= 0.6, p <0.001). </p><p>Conclusion: Reanastomosis of bowel is associated with improved enteral autonomy in SBS children with stoma. Less IFALD and improved survival were also observed. Limiting the duration of bowel discontinuity predicts the likelihood of enteral autonomy.</p>