Complications of enterostomy and related risk factor analysis of very early onset inflammatory bowel disease with interleukin-10 signalling deficiency: a single-centre retrospective analysis

BMC Gastroenterology

卷:20

Weili Yan¹  Yi Zhang¹  Ying Huang²  Zifei Tang²  Zhuowe Yu²  Zhiheng Huang²  Yuhuan Wang²  Peng Shi³  Min Ji⁴  Ying Gong⁴  Kuiran Dong⁵ 

[1] Department of Clinical Epidemiology, Children’s Hospital of Fudan University;

[2] Department of Gastroenterology, Children’s Hospital of Fudan University;

[3] Department of Information, Children’s Hospital of Fudan University;

[4] Department of Radiology, Children’s Hospital of Fudan University;

[5] Department of Surgery, Children’s Hospital of Fudan University;

关键词: IL10/IL10R;    Very early onset inflammatory bowel disease;    Enterotomy;   

DOI  :  10.1186/s12876-020-1160-4

来源: DOAJ

【 摘 要 】

Abstract Background Interleukin-10 (IL10) signalling pathway deficiency results in severe very early onset inflammatory bowel disease (VEOIBD), and enterostomy is often inevitable. However, studies in these surgical populations are lacking. This study aims to determine the enterostomy characteristics, postoperative complications and related risk factors in enterostomy patients. Methods From March 1, 2015, to December 31, 2018, patients with IL10R-mutation who underwent enterostomy were recruited for analysis. We collected data on the patients’ clinical characteristics, enterostomy characteristics, postoperative complications and related risk factors. Results Twelve patients required emergency enterostomy, and 10 patients underwent elective enterostomy. Twelve patients experienced postoperative complications, including wound infection (27.3%), wound dehiscence (18.2%), reoperation (18.2%), etc. Compared with the pre-enterostomy values, there was a decrease in C-reactive protein (CRP) (P = 0.001), an increase in albumin (P = 0.001) and an improvement in the weight-for-age (P = 0.029) and body mass index (BMI) Z-scores (P = 0.004) after enterostomy. There was a significant difference between the pre-operation and postoperation medicine expenses (P = 0.002). Univariate binary logistic regression analysis revealed a statistically significant influence of CRP (OR: 1.43, 95% CI: 1.07–1.91, P = 0.016) and a tendency towards a significant influence of intestinal perforation, albumin level, BMI Z-score and weighted paediatric Crohn’s disease activity index (wPCDAI). Multivariate logistic regression analysis showed that CRP (OR: 1.40), wPCDAI (OR: 2.88) and perforation (OR: 1.72) showed a tendency to behave as independent risk factors for postoperative complications, but the results were not significant (all P > 0.05). Conclusions Surgery and enterostomy showed benefits for VEOIBD with IL-10 signalling deficiency. The timing of intervention, potential postoperative complications, economic burden and other related problems should be considered.

【 授权许可】

Unknown