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Ileocecal valve preservation reduces parenteral nutrition duration and catheter-related bloodstream infections in pediatric short bowel syndrome: a retrospective cohort study.
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Zhou Zhixuan, Wu Qingqing, Feng Haixia, Lu Lina, Yan Weihui, Cai Wei, Wang Ying
Аннотация
OBJECTIVE: To evaluate the clinical significance of the ileocecal valve (ICV) in pediatric short bowel syndrome (SBS) regarding parenteral nutrition (PN) dependence, nutritional status, and complications.
METHODS: A retrospective cohort study was conducted at Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, involving 140 pediatric SBS patients. Patients were divided into ICV-preserved (n = 80) and ICV-absent (n = 60) groups. Outcomes assessed included PN weaning success, PN duration, intestinal failure-associated liver disease (IFALD), catheter-related bloodstream infections (CRBSI), deficiencies in vitamin D and trace elements, and liver function parameters.
RESULTS: Compared with the ICV-absent group, ICV-preserved patients had a higher PN weaning success rate (88.0% vs. 71.2%, p = 0.015), a shorter median PN duration (107 vs. 160 days, p = 0.004), and a lower incidence of CRBSI (37.3% vs. 64.4%, p = 0.002). No significant difference was observed in IFALD incidence (42.7% vs. 57.6%, p = 0.086). Among ICV-absent patients, preservation of > 50% of the colon was associated with improved PN weaning success (77.8% vs. 50.0%, p = 0.045). Initial stoma creation (vs. primary anastomosis) was associated with higher rates of IFALD (56.1% vs. 38.5%, p = 0.047) and CRBSI (57.3% vs. 36.5%, p = 0.019). Vitamin D deficiency was highly prevalent (86.5%) with no significant difference between groups.
CONCLUSION: ICV preservation in pediatric SBS is associated with reduced PN dependence and lower CRBSI risk, underscoring its clinical importance.
METHODS: A retrospective cohort study was conducted at Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, involving 140 pediatric SBS patients. Patients were divided into ICV-preserved (n = 80) and ICV-absent (n = 60) groups. Outcomes assessed included PN weaning success, PN duration, intestinal failure-associated liver disease (IFALD), catheter-related bloodstream infections (CRBSI), deficiencies in vitamin D and trace elements, and liver function parameters.
RESULTS: Compared with the ICV-absent group, ICV-preserved patients had a higher PN weaning success rate (88.0% vs. 71.2%, p = 0.015), a shorter median PN duration (107 vs. 160 days, p = 0.004), and a lower incidence of CRBSI (37.3% vs. 64.4%, p = 0.002). No significant difference was observed in IFALD incidence (42.7% vs. 57.6%, p = 0.086). Among ICV-absent patients, preservation of > 50% of the colon was associated with improved PN weaning success (77.8% vs. 50.0%, p = 0.045). Initial stoma creation (vs. primary anastomosis) was associated with higher rates of IFALD (56.1% vs. 38.5%, p = 0.047) and CRBSI (57.3% vs. 36.5%, p = 0.019). Vitamin D deficiency was highly prevalent (86.5%) with no significant difference between groups.
CONCLUSION: ICV preservation in pediatric SBS is associated with reduced PN dependence and lower CRBSI risk, underscoring its clinical importance.