310 Appendices formation and closure. These results show how common these severe complications are. These risk should be taken into account during clinical decision making Afterwards we set out to evaluate the effects of the presence, level and time of closure of an enterostomy. In our cohort, 61% of the patients showed a growth decline. Moreover, severe malnourishment at closure occurred in 51% treated by small bowel enterostomies and 16% of those treated by colostomies. Within a year following closure, 67% showed positive growth tendency. Having a proximal small bowel enterostomy and undergoing major small bowel resection led to significantly lower Z-scores at closure. Adequate sodium supplementation and early closure didn’t lead to significant changes in Z-scores. These two studies showed the increased risks as a result of treatment by enterostomy. If there is a choice, these risks could lead to opting out of creating one, choosing a primary anastomosis instead. An example of a condition where there is still no consensus if primary anastomosis or treatment by enterostomy is the best treatment are jejunoileal atresias. Therefore we wanted to evaluate in our retrospective cohort which of the two treatments resulted in the least complications. Our results show that significantly more major complications (Clavien-Dindo ≥III) occurred following treatment by enterostomy. Moreover both short-term (SSI and wound dehiscence) and long-term (short bowel syndrome and SBO) complications occurred more often when treated by enterostomy. Though based on a retrospective cohort, and though perioperative factors might necessitate enterostomy formation, based on these results we advise a low threshold for performing a primary anastomosis in this cohort of patients. Before enterostomy closure, it was daily practice in our centre to perform a contrast enema prior to evaluate if there were strictures present. However, there no evidence supporting this practice which is why we set out to evaluate the diagnostic accuracy of a contrast enema in identifying intestinal strictures. Our results show that strictures are identified almost exclusively following treatment for necrotizing enterocolitis. The detection rate of these strictures by contrast enema is high with an AUC of 0.98. For this reason we advise to only perform contrast enemas in patients treated for NEC.
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