Morbidity and mortality of colostomy and its closure in children

Chandramouli, Bangalore A.; Srinivasan, Krishnamachari; Jagdish, S; Ananthakrishnan, N

doi:10.1016/j.jpedsurg.2003.12.016

Cited by 91 publications

(105 citation statements)

References 14 publications

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“…Our SSI rate was 9.2 %. Rates of SSI due to ostomy closure vary between 0 and 36 % in the literature [4, <0.001 5,14,15]. The mean SSI rate was 14 % (17/118) in a similar study where the incisions were primarily closed after ostomy closure in children, and SSI rates did not differ according to bowel cleansing and preoperative and postoperative antibiotic regimens, which supports our own findings [10].…”

Section: Discussionsupporting

confidence: 82%

Ostomy Closures in Children: Variations in Perioperative Care Do Not Change the Outcome

Çavuşoğlu¹,

Karaman²,

Afşarlar³

et al. 2015

Indian J Surg

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This study aimed to evaluate ostomy closure applications and outcomes and determine the effect of personal differences among surgeons on patient postoperative course. Ninety-eight patients who underwent elective ostomy (ileostomy and colostomy) closure for 8 years at a pediatric surgery training department were investigated. Postoperative complications included superficial surgical site infection (SSI; 9.4 %), organ/cavity infection (1 %), small bowel adhesions (8.2 %), and incisional hernia (1 %). SSI and postoperative complications were not affected by the preoperative antibiotic regimen used. Operation duration, pre-and postoperative antibiotic use durations, postoperative inpatient period, ostomy type, primary diagnosis, performance of abdominal exploration, SSI, and postoperative complications were not significantly different. However, the time of nasogastric (NG) tube withdrawal, time to oral feeding initiation, abdominal closure method used, and preoperative antibiotic regimen were significantly different among different surgeons. We conclude that while surgeons used different preoperative antibiotic regimens and abdominal closure methods and stipulated different times for NG tube withdrawal and oral feeding initiation, the postoperative course and prognosis were unaffected Thus, the preand postoperative inpatient period and antibiotic use duration can be decreased in children by procedure standardization using practice guidelines; the procedures can also be performed with a more aesthetic, acceptable incision.

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Section: Discussionsupporting

confidence: 82%

Ostomy Closures in Children: Variations in Perioperative Care Do Not Change the Outcome

Çavuşoğlu¹,

Karaman²,

Afşarlar³

et al. 2015

Indian J Surg

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“…The present described laparoscopic procedure, as with all other surgical interventions, may also lead to minor complications such as skin infection and discomfort during management of the colostomy bag after surgery. [7][8][9] Severe wound infection, stoma prolapse, and evisceration can also occur.…”

Section: Discussionmentioning

confidence: 99%

Untitled

2015

MOJS

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This is a description of the technique used for laparoscopy-assisted colostomy in neonates with anorectal malformations (ARM), using 2 laparoscopic ports only. The technique is easy to use and has the advantages of enabling identification of the sigmoideum, the internal genitals and to establish a stoma leaving only minimal scars in the umbilicus. In our departments, we routinely perform stoma operations using this technique. We do not claim any benefits or disadvantages of LAC compared with the traditional open technique.Keywords: colostomy, neonates, anorectal malformation (ARM), laparoscopy, laparoscopic colostomy MOJ Surgery Mini Review Open AccessTwo ports laparoscopy-assisted colostomy in neonates-a method described Citation: Gunnarsdóttir A, Stenström P, Arnbjörnsson E. Two ports laparoscopy-assisted colostomy in neonates-a method described. MOJ Surg. 2015;2(2):21-23.

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“…Chandramouli, et al [1] reported that revision was needed in 2 of 30 children (6.7%) with external intestinal prolapse for significant obstructive stomal prolapse [3]. Four patients (6% of the prolapse group) were subjected to an extra operative procedure because of prolapse.…”

Section: Discussionmentioning

confidence: 99%

“…One attempt was made to fix the prolapsing bowel to the parietal peritoneum, using open laparotomy and multiple suture points of fixation, but this prolapse recurred. Chandramouli, et al [1] reported that 2 prolapses were treated by advancement and amputation of the prolapsing segments, with reconstruction of the colostomy in the same location but separating the 2 limbs by a fascial bridge [3]. Al-Salem, et al [7] reported that stomal revision was required because of frequent prolapse in 2 of 14 children who suffered prolapse.…”

Section: Discussionmentioning

confidence: 99%

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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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Morbidity and mortality of colostomy and its closure in children

Cited by 91 publications

References 14 publications

Ostomy Closures in Children: Variations in Perioperative Care Do Not Change the Outcome

Ostomy Closures in Children: Variations in Perioperative Care Do Not Change the Outcome

Untitled

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

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