Royal Manchester Children’s Hospital doctor awarded funding to study best time to perform surgery on newborn babies

A Royal Manchester Children’s Hospital consultant has been awarded nearly £400,000 to carry out research into ‘early vs late’ stoma closure in babies.

Some babies born prematurely, or with birth defects, require lifesaving surgery on their tummy. As part of this surgery, a stoma – which is where ends of the bowel are brought to the skin surface to allow the baby to ‘poo’ into a bag – is frequently required temporarily.

Although a stoma can be lifesaving, there are problems associated with them, as babies may get dehydrated, have poor growth and have problems with their skin. Reversing or ‘closing’ the stoma, with a second operation, is therefore a key part of the baby’s care.

Mr Nick Lansdale, Consultant Paediatric and Neonatal Surgeon at Royal Manchester Children’s Hospital (RMCH), said: “The time when the stoma is closed is important, as it may affect when the baby can feed with milk without a drip, how well the baby grows and when the baby can go home.

“However, the time of this stoma closure is known to vary significantly between hospitals and between different surgeons.

The best time to do this operation is currently uncertain and research is needed to find this out.

As such, Mr Lansdale will lead a feasibility study – ‘Timing of Stoma Closure in Neonates’ – or ToSCiN.

ToSCiN aims to determine whether or not it is feasible to conduct a clinical trial comparing ‘early vs late’ stoma closure. It will define current practice, establish whether a clinical trial is acceptable to parents and doctors and determine what a trial should look like, in terms of which babies to include and how it would take place.

Mr Lansdale has been awarded grant funding to carry out the study as part of the NIHR Health Technology Assessment (HTA) programme. The programme funds research about the clinical and cost-effectiveness and broader impact of healthcare treatments and tests for those who plan, provide or receive care from NHS and social care services.

Manchester University NHS Foundation Trust (MFT), of which RMCH is part, will sponsor and lead the study.

Mr Lansdale added: “One of the outstanding questions relating to stomas in newborns is when it is best to close them. There are currently no recommendations on when to do this and current practice is based on surgeon’s preferences or local protocols.

This research will help us gather evidence to inform best practice, which will potentially improve future outcomes for the babies we care for in Manchester and across the NHS.

“I would like to thank the NIHR for awarding the funding, MFT for supporting my application, my co-applicants and our partners at other ToSCIN study sites across the UK.”

Find out more about ToSCIn on the NIHR website.