Colostomy for anorectal anomalies: High incidence of complications

Patwardhan, Nitin; Kiely, Edward M.; Drake, D. P.; Spitz, Lewis; Pierro, Agostino

doi:10.1053/jpsu.2001.22963

Cited by 98 publications

(67 citation statements)

References 8 publications

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“…The mean interval between colostomy and closure was 10.7months with a range of 2-36 months, quite similar to finding by Nasir, et al [19] in their study also from a developing world, but contrasts with the work by Patwardhan, et al [20] whose mean interval was 6 months. This variation could be as a result of poverty and paucity of man power and resources leading to a long waiting list [19].…”

Section: Discussionsupporting

confidence: 81%

Outcome of Colostomies in Children: A Review of 48 Cases at Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

Ugwu¹

2017

J.Paedi.Care.Inol

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Section: Discussionsupporting

confidence: 81%

Outcome of Colostomies in Children: A Review of 48 Cases at Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

Ugwu¹

2017

J.Paedi.Care.Inol

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“…They, however, expressed that colostomy represents a significant source of morbidity and mortality. Colostomy complications in these children were recently highlighted by Patwardhan et al 8 at the Great Ormond Street Hospital London. These complications are even more serious in developing countries where most of the parents are illiterates and there are no colostomy bags and no stoma nurses.…”

Section: Discussionmentioning

confidence: 92%

One-stage correction of intermediate imperforate anus in males: preliminary results

Adeniran¹,

Abdur-Rahman²,

Bolaji³

2010

Nigerian Journal of Surgical Research

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Background: This prospective study was designed to assess the safety, cost effectiveness, and advantages of performing posterior sagittal anorectoplasty without colostomy on males with intermediate imperforate anus. Method: Five consecutive males with intermediate imperforate anus were entered into the study. Chest and abdominal x-rays, skeletal surveys, renal ultrasound scans, and invertograms were done. Patients were resuscitated, and Pena's posterior sagittal anorectoplasty (PSARP) done in prone positions. Two-ml syringe vents were inserted into the new anus for 10 days. Cephalosporin and metronidazole were given as peri-operative antibiotics. Results: All patients had intermediate anomalies. There were no other major associated congenital anomalies. Urethral catheter could not be inserted in one patient. One patient presented with septicaemia and jaundice. He was deemed too ill to withstand a major operation. These 2 patients therefore had diverting colostomies. There were no problems with posterior sagittal anorectoplasty in the other 3 patients. The father of one patient discharged him against medical advice on the 5 th postoperative day. The mother had post-partum haemorrhage and they went for traditional treatment because they could not provide blood donors. The skin wound of 2 patients healed completely at removal of stitches. Both are having monthly dilatations 9months and 1 year post-operatively.Conclusion: This preliminary study shows that it is feasible for males with intermediate imperforate anus to have safe posterior sagittal anorectoplasty without colostomy. The advantages of one, instead of 3 major operations, are many, especially in developing countries. If this result can be reproduced in high anomalies colostomy may be unnecessary in many cases of anorectal malformations with a lot of benefits to these unfortunate children and their poor families.

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“…However, another report found no significant difference regarding the location of the loops, whereas the prolapse rate was greater for loop than for divided colostomies [8]. According to the stomal site, the tendency for transverse colostomy to prolapse was reported previously to be 3 in 7 patients with transverse colostomy, and prolapse may have been caused by the fact that the transverse colon is relatively mobile [8]. It was more frequent in emergency stomas created for obstruction or stoma brought through the main operative incision [6].…”

Section: Discussionmentioning

confidence: 90%

“…Chandler, et al [3] reported that the loops demonstrated a greater propensity to prolapse the more proximally they were located. However, another report found no significant difference regarding the location of the loops, whereas the prolapse rate was greater for loop than for divided colostomies [8]. According to the stomal site, the tendency for transverse colostomy to prolapse was reported previously to be 3 in 7 patients with transverse colostomy, and prolapse may have been caused by the fact that the transverse colon is relatively mobile [8].…”

Section: Discussionmentioning

confidence: 95%

See 1 more Smart Citation

Technical Points Regarding New Enterostomy Formation for Incarcerated Stomal Prolapse in Loop Enterostomy

Okada¹,

Honda²,

Miyagi³

et al. 2011

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Aim: Incarcerated stomal prolapse is a rare complication of enterostomy. Numerous procedures have been described, such as additional laparotomy to fix the intraabdominal intestine in place, enterostomy revision, or correction of the prolapse following stoma creation. The authors report successful managements by stomal reconstruction and discuss several clinical points, including the techniques of surgical revision for incarcerated stomal prolapse in loop enterostomy. Patients: Case 1) A female infant weighing 2755 g was delivered at 34 weeks of gestation. On the first day after birth, a right supra-abdominal transverse incision of 10 cm in diameter was used for transverse loop colostomy in a cloacal malformation. Two centimeters of the stomal loop was approximated with sutures to prevent evisceration of the small intestine between the 2 limbs of the loop. Interrupted sutures of 5-0 absorbable monofilament secured the seromuscle of the colon to the peritoneum and fascia, and also to the skin. The distal limb of the colostomy prolapsed 11 months after birth. The physical findings revealed that 10 cm of the distal limb was intussuscepted. Case 2) A female infant weighing 2550 g was delivered at 39 weeks of gestation. A radiological examination by contrast enema showed no spastic rectum and colon, as in Hirschsprung's disease. Under the laparotomy of a right supra-abdominal transverse incision of 5 cm in diameter, loop ileostomy was performed at 30cm on the proximal side of the cecum such as Case 1. Subsequently, the proximal limb of the ileostomy prolapsed 2 days after operation. The physical findings revealed that 10 cm of the proximal limb was intussuscepted. New enterostomy formation: Divided enterostomy was performed with 3-cm stitching of each limb. The stomal site was moved to the inside from the previous stomal site to oversew and fix by the rectal fascia. The children have been well without trouble since undergoing the new eneterostomy formation. Conclusions: Operation to repair the prolapse of a stoma is advised if it causes problems. We found that simple mobilization of the bowel and excision of the redundant bowel provided a satisfactory result in the present cases.

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Colostomy for anorectal anomalies: High incidence of complications

Cited by 98 publications

References 8 publications

Outcome of Colostomies in Children: A Review of 48 Cases at Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

Outcome of Colostomies in Children: A Review of 48 Cases at Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

One-stage correction of intermediate imperforate anus in males: preliminary results

Technical Points Regarding New Enterostomy Formation for Incarcerated Stomal Prolapse in Loop Enterostomy

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