228 Chapter 10 stoma prolapse (5%, n=14/307), and stoma stenosis (2%, n=6/307). Overall a complication, either within or after 30 days, occurred in 27% of the patients after stoma creation (n=92/336). Of all young children, 87% (n=292/336) underwent stoma closure. Stoma closure was not performed in 38 patients since they died before stoma closure could be performed. In four patients a permanent stoma was already intended at initial surgery. The remaining two young children are awaiting their stoma closure. Following stoma closure, 5% (n=16/292) of the young children received a new stoma due to post-operative morbidity or functional problems, of which four underwent construction of a permanent colostomy. Following stoma closure, major stoma related morbidity occurred in 8% (n=24/292) of the patients within 30 days (Table 3). The most commonly occurring complications were anastomotic leakage (2%, n=6/292), anastomotic stenosis (2%, n = 5/292), and central line sepsis (1%, n=3/292). After 30 days, a complication was registered in 16% (n=47/288) of patients, mostly comprising incisional hernia (6%, n=17/288), anastomotic stenosis (5%, n=13/288), and adhesive obstruction (4%, n=12/288). Overall stoma related morbidity rate either within or after 30 days was 23% (n=66/292). Overall, major stoma related morbidity, either after stoma formation and/or after closure, occurred in 39% (n=130/336) of the young children. Of the patients that underwent stoma closure 10% (n=28/288) had a high grade complication after stoma formation, as well as after stoma closure. Over time, splitting the cohort into four groups of five consecutive years, there was no significant change in overall major stoma related morbidity rates (p=0.52). Young children treated with an ileostomy were more at risk of major stoma related morbidity after stoma formation compared to young children treated with a colostomy (OR 2.5; 95%-CI 1.3-4.7, ≤0.01). Gender (p=0.35), having had a surgical procedure before stoma formation (p=0.76), inflammatory disease (p=0.44), prematurity (p=0.47), weight at stoma formation (p=0.14) and the need for vasopressin after stoma formation (p=0.31) were not related to the risk of major stoma related morbidity (Supplementary Table 2). Following stoma closure, patients with an ileostomy were also more at risk of major stoma related morbidity (OR:2.7; 95%-CI:1.3-5.8, ≤0.01). Inflammatory disease (p=0.22), weight at stoma closure (p=0.18), time to stoma closure in days (p=0.82), and suture resorption speed (p=0.84) did not significantly affect the risk of stoma related morbidity (Supplementary Table 3).
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