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Long-term intestinal obstruction sequelae and growth in children with cystic fibrosis operated for meconium ileus: expectancies and surprises.
J Pediatr Surg 2018; 53(8):1504-1508JP

Abstract

BACKGROUND/PURPOSE

In the few studies on intestinal complications and growth of cystic fibrosis (CF) patients with a history of meconium ileus (MI), operated MI has not been investigated separately. We aimed to investigate the incidence of long-term intestinal obstruction sequelae [constipation, distal intestinal obstruction syndrome (DIOS)] and growth in CF patients operated for MI.

METHODS

Retrospective study (1989-2016) including operative diagnoses and procedures, constipation and DIOS events, yearly Body Mass Index (BMI) measurements. Outcomes were examined in subgroups operated for MI only and for MI with atresia and/or volvulus.

RESULTS

Of 49 patients followed-up for 15 (mean) years, 5 (10.2%) developed constipation and 14 (28.6%) DIOS. BMI was within normal percentiles in 53 patients over a 10-year follow-up. MI only and MI with atresia and/or volvulus did not differ in constipation and/or DIOS incidence (11/34 vs. 7/15, p=0.39) or in BMI (p=0.47). Cases with ileocecal valve resection (ICV-R) showed lower constipation and/or DIOS incidence than those without ICV-R (0/6 vs. 11/28, p=0.02) and no different BMI (p>0.05).

CONCLUSIONS

CF patients operated for MI were in long-term risk for constipation/DIOS; their growth was normal. Interestingly, underlying atresia/volvulus neither increased constipation/DIOS risk nor affected growth. Strikingly, ICV-R showed no constipation/DIOS risk and no impact on growth.

TYPE OF STUDY

Retrospective comparative study.

LEVEL OF EVIDENCE

III.

Authors+Show Affiliations

Department of Pediatric Surgery, 'Aghia Sophia' Children's Hospital, Athens, Greece.Center of Cystic Fibrosis, 'Aghia Sophia' Children's Hospital, Athens, Greece.Department of Pediatric Surgery, 'Aghia Sophia' Children's Hospital, Athens, Greece.Department of Pediatric Surgery, 'Aghia Sophia' Children's Hospital, Athens, Greece.Department of Pediatric Surgery, 'Aghia Sophia' Children's Hospital, Athens, Greece.Department of Pediatric Surgery, 'Aghia Sophia' Children's Hospital, Athens, Greece. Electronic address: pmirilas@gmail.com.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29224788

Citation

Mentessidou, Anastasia, et al. "Long-term Intestinal Obstruction Sequelae and Growth in Children With Cystic Fibrosis Operated for Meconium Ileus: Expectancies and Surprises." Journal of Pediatric Surgery, vol. 53, no. 8, 2018, pp. 1504-1508.
Mentessidou A, Loukou I, Kampouroglou G, et al. Long-term intestinal obstruction sequelae and growth in children with cystic fibrosis operated for meconium ileus: expectancies and surprises. J Pediatr Surg. 2018;53(8):1504-1508.
Mentessidou, A., Loukou, I., Kampouroglou, G., Livani, A., Georgopoulos, I., & Mirilas, P. (2018). Long-term intestinal obstruction sequelae and growth in children with cystic fibrosis operated for meconium ileus: expectancies and surprises. Journal of Pediatric Surgery, 53(8), pp. 1504-1508. doi:10.1016/j.jpedsurg.2017.11.040.
Mentessidou A, et al. Long-term Intestinal Obstruction Sequelae and Growth in Children With Cystic Fibrosis Operated for Meconium Ileus: Expectancies and Surprises. J Pediatr Surg. 2018;53(8):1504-1508. PubMed PMID: 29224788.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term intestinal obstruction sequelae and growth in children with cystic fibrosis operated for meconium ileus: expectancies and surprises. AU - Mentessidou,Anastasia, AU - Loukou,Ioanna, AU - Kampouroglou,Georgios, AU - Livani,Anastasia, AU - Georgopoulos,Ioannis, AU - Mirilas,Petros, Y1 - 2017/11/15/ PY - 2017/05/29/received PY - 2017/10/21/revised PY - 2017/11/07/accepted PY - 2017/12/12/pubmed PY - 2018/11/1/medline PY - 2017/12/12/entrez KW - Body mass index KW - Constipation KW - Cystic fibrosis KW - Distal intestinal obstruction (DIOS) KW - Growth curves KW - Meconium ileus SP - 1504 EP - 1508 JF - Journal of pediatric surgery JO - J. Pediatr. Surg. VL - 53 IS - 8 N2 - BACKGROUND/PURPOSE: In the few studies on intestinal complications and growth of cystic fibrosis (CF) patients with a history of meconium ileus (MI), operated MI has not been investigated separately. We aimed to investigate the incidence of long-term intestinal obstruction sequelae [constipation, distal intestinal obstruction syndrome (DIOS)] and growth in CF patients operated for MI. METHODS: Retrospective study (1989-2016) including operative diagnoses and procedures, constipation and DIOS events, yearly Body Mass Index (BMI) measurements. Outcomes were examined in subgroups operated for MI only and for MI with atresia and/or volvulus. RESULTS: Of 49 patients followed-up for 15 (mean) years, 5 (10.2%) developed constipation and 14 (28.6%) DIOS. BMI was within normal percentiles in 53 patients over a 10-year follow-up. MI only and MI with atresia and/or volvulus did not differ in constipation and/or DIOS incidence (11/34 vs. 7/15, p=0.39) or in BMI (p=0.47). Cases with ileocecal valve resection (ICV-R) showed lower constipation and/or DIOS incidence than those without ICV-R (0/6 vs. 11/28, p=0.02) and no different BMI (p>0.05). CONCLUSIONS: CF patients operated for MI were in long-term risk for constipation/DIOS; their growth was normal. Interestingly, underlying atresia/volvulus neither increased constipation/DIOS risk nor affected growth. Strikingly, ICV-R showed no constipation/DIOS risk and no impact on growth. TYPE OF STUDY: Retrospective comparative study. LEVEL OF EVIDENCE: III. SN - 1531-5037 UR - https://www.unboundmedicine.com/medline/citation/29224788/Long_term_intestinal_obstruction_sequelae_and_growth_in_children_with_cystic_fibrosis_operated_for_meconium_ileus:_expectancies_and_surprises_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3468(17)30759-5 DB - PRIME DP - Unbound Medicine ER -