The Timing of Stoma Closure in Infants with Necrotizing Enterocolitis: A Systematic Review and Meta-Analysis
Bibliographic record
Abstract
Aim Some infants with necrotizing enterocolitis (NEC) undergoing surgery require the formation of a stoma. The timing of stoma closure in these patients remains controversial. Our aim was to determine whether the different timing of closure had an impact on patient outcome. Methods Using a defined search strategy (PubMed, Embase, and Web of Science), two investigators (Q.L. and G.L.) independently identified studies comparing early stoma closure (ESC, before 8 weeks from stoma formation) versus late stoma closure (LSC, after 8 weeks) in infants with NEC. Outcome measures included the duration of parenteral nutrition, the length of hospital stay, and complications. Meta-analysis was performed using RevMan 5.3 (The Cochrane Collaboration, Copenhagen, Denmark). Data are expressed as mean ± standard deviation. Results Of the 505 articles screened, 6 articles met the inclusion criteria (280 infants). All studies but one were retrospective. The total duration on parenteral nutrition was similar in infants with ESC versus LSC, and the total length of hospital stay (pre- plus poststoma closure) was not influenced by the timing of stoma closure. Three studies (79 infants) reported similar complication rates after stoma closure between ESC (5/16, 31%) and LSC infants (13/63, 19%; p = 0.5). Conclusions This systematic review demonstrates that there is no difference between different timings for stoma closure in post-NEC infants. With the current supporting evidence, ESC seems to be as safe and feasible as LSC. Studies with a higher level of evidence are needed to confirm these conclusions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.028 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.019 | 0.038 |
| Bibliometrics | 0.006 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".