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.

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.

• Authors: Zifei Tang, Zhiheng Huang, Weili Yan, Yi Zhang, Peng Shi, Kuiran Dong, Ying Gong, Min Ji, Yuhuan Wang, Zhuowe Yu, Ying Huang
• Journal: BMC gastroenterology (BMC Gastroenterol) Vol. 20 Issue 1 Pg. 8 (Jan 13 2020) ISSN: 1471-230X [Electronic] England
• PMID: 31931724 (Publication Type: Journal Article)

Chemical References

• IL10 protein, human
• Receptors, Interleukin-10
• Interleukin-10

Topics

• Adolescent
• Adult
• Age of Onset
• Child
• Child, Preschool
• Cost of Illness
• Enterostomy (adverse effects, economics)
• Female
• Humans
• Inflammatory Bowel Diseases (economics, genetics, surgery)
• Interleukin-10 (genetics)
• Logistic Models
• Male
• Mutation
• Postoperative Complications (economics, genetics)
• Postoperative Period
• Preoperative Period
• Receptors, Interleukin-10 (deficiency)
• Retrospective Studies
• Risk Factors
• Signal Transduction (genetics)
• Young Adult