Colostomy Closure in Pediatric Age Group: Analysis Of Out Come in Single Center Exp erience

Abstract

Background: Closure colostomy is a common procedure in the pediatric surgical practice, considered a major one because it involves anastomosis of the large bowel, and requires strict bowel preparation and prophylactic antibiotics. It’s the last event in the management of some pediatric surgical conditions, as Hirschsprung’s disease and anorectal malformations.
Objectives: To evaluate the complications of colostomy closure in pediatric patients.
Patients and methods: A total of 106 patients underwent colostomy closure were enrolled in this prospective study conducted in Welfare Teaching Hospital in Medical City Complex, from October 2015 to January 2017, were reviewed looking for complications following closure colostomy. Data were collected including age, gender, indication of colostomy, type and location of colostomy, presence of stoma complication, and presence of associated anomalies. Details of colostomy closure, including pre-operative, intra-operative and post-operative variables were recorded.
Results: Of 106 patients included, there were 38(35.8%) females and 68(64.2%) males, with an average age of 2.4 years. Indications for colostomy were Hirschsprung’s disease 58(54.7%) and anorectal malformations 48(45.3%). The site of colostomy was transverse colon 54(50.9%), and sigmoid colon 52(49.1%). The type of colostomy was divided 8(7.5%) and loop 98(92.5%). Forty-eight patients (45.3%) developed complications; the most common being wound infection 30 (28.3%), followed by fecal fistula 6 (5.7%), wound dehiscence 4 (3.8%), adhesive intestinal obstrution 4 (3.8%) and incisional hernia 4 (3.8%).
Conclusion: Closure colostomy is a high morbidity procedure. With morbidity rate of 45.3%, the highest complications were wound infection.
Keywords: Hirschsprung’s disease (HD), Anorectal malformation (AM)

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