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19–22 APRIL, 2017, BARCELONA, SPAIN
17:04–17:07
S12-3 (PP)
★
BOWEL MANAGEMENT IN AUGMENTATION
AND DIVERSON SURGERY USING SMALL BOWEL
IN CHILDREN: EVALUATION OF A NEW, CONTEMPORARY
PROTOCOL
Bernhard HAID
1
, Judith ROESCH
2
, Tanja BECKER
2
, Mark KOEN
2
,
Christoph BERGER
2
, Christa STRASSER
2
, Anton HAID
3
and Josef OSWALD
2
1) Hospital of the Sisters of Charity, Pediatric Urology, Linz, AUSTRIA - 2) Hospital of the Sisters of Charity, Department
of Pedatric Urology, Linz, AUSTRIA - 3) Feldkirch General Hospital, Department of General and Thoracic Surgery,
Feldkirch, AUSTRIA
PURPOSE
In children undergoing surgical interventions with anastomosis of small bowel a preoperative “bowel
preparation” regimen including the use of laxatives and enemas is common. Contrariwise, early
enteral feeding, omitting any period of fasting or parenteral nutrition is uncommon and parenteral
nutrition is often used. Although there is an eminent lack of literature concerning children in that field,
we recently changed our bowel and nutrition management in children undergoing augmentation and
diversion surgery.
MATERIAL AND METHODS
After omitting as well the preoperative laxative treatment and introducing early enteral feeding with
no postoperative fasting period, we prospectively evaluated complications, time to stool as well
as total hospital stay in 10 consecutive patients. These findings were compared to the data of
10 consecutive patients before the changes in protocol were effective. The groups were comparable
in age (8.3 vs. 11.3 years, p=0.128) and mean and operative time (328 vs. 375mins, p=0.399).
2 patients with other reasons for nutritional problems (e.g. long ICU stay, not bowel related surgical
complication) were excluded.
RESULTS
The change in protocol led to no bowel related complication or problem. Time to stool (3.1 vs.
5.4 days, p=0.003) as well as hospital stay (11.6 vs. 19.1 days, p=0.002) were significantly shorter
using the new protocol. Whereas before the protocol change bowel related symptoms requiring
additional medication were present in 5 children (3 thereof requiring distigmin/stomach tube) no
child required any intervention after the change.
CONCLUSIONS
If the use of small bowel in pediatric urologic surgery is planned, neither a „bowel preparation
regimen“ nor a postoperative fasting period is necessary.