e- [:1€¦ · (33,3 %), the most common complication was wound sepsis in 5 children, in...
TRANSCRIPT
11
Vo l. 8 , No, 1. June 2002
Stomal Complications in Children
Joong-Jai Park, M.D., Joo-Hong Lee, M.D., Jong-Do Jung, M.D.,
Young-Cheol Choi, M.D., Woo-Shik Chung, M.D., Si-Youl Jun, M.D.
Department of Surgery, Masan Samsung Hospital, Sungkyunkwan University College of Medicine,
Masan, Korea
This is a 20 year analysis of the problems associated with enterostomy formation, and closure,
Forty-three stomas were established in 43 patients: 23 for anorectal malformations, 11 for Hirschsprung's diseases, 4 for necrotizing enterocolitis, 3 for multiple ileal atresias , 1 for
volvulus neonatorum with perforation, and 1 for diaphragmatic hernia with colon perforation, Thirty boys and 13 girls were included (mean age 4,8 months), Stoma complications were encountered in 13 patients (30,2 %): stomal prolapse , stenosis, obstruction, paracolic hernia,
retraction, dysfunction, and skin excoriation, Four patients (9,3 %) required stomal revision,
Occurrence of complications was not related to age and primary disease, but sigmoid colostomy
showed lower complication rate than transverse colostomy (20 ,0 % vs 42,9 %, p(0,05) , There were
five deaths but, only one (2,3 %) was directly related to the enterostomy complication,
Twenty-one stomas were closed in Qur hospital and complications occurred in seven patients
(33,3 %), The most common complication was wound sepsis in 5 children, In conclusion, because
the significant morbidity of stomal formation still exists, refinements of the surgical technique
seem to be required, Sigmoid loop colostomy is preferred whenever possible,
(J Kar Assoc Pediatr Surg 8(1):11 - 15), 2002.
Index Words: Colostomy, Complication, Child
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Correspondence: Si-Youl lull, MD., Department of Surgery,
Sungkyunkwan University College of Medicine, Masan Samsung
Hospital, 50 Hapsung-dong, Masan 630-522, Korea
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12
Table 1. Indication and Sex Distribution for Stoma Formation
Indications No. of patients(%) M/F
Anorectal malformation
Hirschsprung's disease
Necrotizing enterocolitis
Bowel atresia
Diaphragmatic hernia with perforation
Volvulus with perforation
Total
Table 2. Age Distribution at Stoma Formation
Age No. of patients (%)
1-28 d 31 72.1
1-11 m
over 1 yr
Total
11
43
25.6
2.3
100
23(53.5)
11 (25.6)
4(9.3)
3(7.0)
1(2.3)
1(2.3)
43(100)
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Table 3. Types of Stoma Formation
Type of colostomy No. of patients (%)
Transverse loop 21 48.8
Sigmoid loop 10 23.3
Ileostomy 6 13.9
Discending double 4 9.3
barrel
Discending end 2 4.7
Total 43 100
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Table 4. Complications after Stoma Formation
Stoma type Prolapse Stenosis Adhesive Parastomal
Retraction Skin
Dysfunction Total obstruction hernia excoriation
Transverse 7*
100p(n=21 )
Sigmoid 1* 0 0 100p(n=10)
Ileum 0 0 100p(n=6)
Discending double 0 barrel( n=4)
Discending 0 0
end(n=2)
Total(n=43) 9 3 2
* p<0.05 (Transverse loop vs Sigmoid loop)
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Table 5. Complications after Colostomy Closure
2
0
0
0
0
2
0 0 12
0 0 2
0 0 2
0 0 0 2
0 0 0
19
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Colostomy type Wound sepsis Adhesive bowel Anastomotic Wound
Total obstruction leakage dehiscence
Transverse 3
100p(n=12) 2 7
Sigmoid 0 0 2
100p(n=4)
Ileum 0 0 0
100p(n=4)
Discending double 0 0
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Discending 0 0 0 0 0
end(n=1 )
Total(n=21 ) 4 3 2 10
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15
I. Goon HK: Repair of anorectal anomalies in the
neonatal period. Pediatr Surg Int 5: 246-249, 1990
2. Pena A: Management of anorectal malformations during
the newborn period. World J Surg 17(3): 385-392, 1993
3. AI-Salem AH, Grant C, Khawaja S: Colostomy com
plications in infants and children. Int Surg 77(3):
164-166, 1983
4. ~Al ~, .I.~0J:, 01J8-§}, ~Al1%, 01%°.1: ?J1lWfl .5: Aj~ 'jj -l¥--&~E/ :W-714=-~.:f- ?J¥J"t-ofl -'f!H! !f!-4. rJl ~.2.]Jrj-~~ Al 33: 372-377, 1987
5. Nour S, Stringer MD, Beck J: Colostomy complications
in infants and children. Ann R Coll Surg Engl 78:
526-530, 1996
6. Mollitt DL, Malangoni MA, Ballantine TV, Grosfeld JL:
Colostomy complications in children. An analysis of 146
cases. Arch Surg lIS: 455-458, 1980
7. 3oli'-~ ~~(!6fJHI ~ *i): ~-t?-trJT S:Aa~: ~0}.2.]Jrj-~"fl
AJ, chap 6, ~A1A}, 1994, Pp65-72
8. O'Connor A, Sawin RS: High morbidity of enterostomy
and its closure in premature infants with enterocolitis.
Arch Surg 133(8): 875-880, 1998
9. Rokhsar S, Harrison EA, Shaul DB, Phillips JD:
Intestinal stoma complications in immunocompromised
children. J Pediatr Surg 34(12): 1257-1261, 1999
10. Patwardhan N, Kiely EM, Drake DP, Spitz L, Pierro A:
Colostomy for anorectal anomalies: High incidence of
complications. J Pediatr Surg 36(5): 795-798, 2001
II . Moore TC: Advantages of performing the sagittal an
oplasty operation for imperforate anus at birth. J
Pediatr Surg 25(2): 276-277, 1990
12. Steinau G, Ruhl KM, Hornchen H, Schumpelick V:
Enterostomy complications in infancy and childhood.
Langenbecks Arch Surg 386(5): 346-349, 2001
13. Wright HK: Improving transverse colostomy function.
Am J Surg 132: 475-477, 1979
14. Golladay ES, Bernay F, Wagner CW: Prevention of
prolapse in pediatric enterostomas with purse string
technique. J pediatr Surg 25(9): 990-991, 1990
IS. Ein SH: Divided loop colostomy that does not prolapse.
Am J Surg 147: 250-252, 1984
16. Smith JAR, Taylor I: Complications of colostomy:
Complications of surgery of lower GI tract (ed 1), chap
9, Oxford, WB Saunders, 1985, Ppi06-128