Muscle splitting sigmoid loop colostomy: a viable option to prevent colostomy prolapse

Chalapathi Gontumukkala; Krishna Naik K.; Ramana Naik; Veera Swamy J.

doi:10.18203/2349-2902.isj20175144

Authors

Chalapathi Gontumukkala Department of Paediatric Surgery, Kurnool Medical College, Kurnool, Andhra Pradesh, India
Krishna Naik K. Department of Paediatric Surgery, Kurnool Medical College, Kurnool, Andhra Pradesh, India
Ramana Naik Department of Paediatric Surgery, Kurnool Medical College, Kurnool, Andhra Pradesh, India
Veera Swamy J. Department of Paediatric Surgery, Kurnool Medical College, Kurnool, Andhra Pradesh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20175144

Keywords:

Anorectal malformations, Hirschsprung’s disease, Loop colostomy

Abstract

Background: The purpose the study was to assess the incidence of Colostomy prolapse with sigmoid loop colostomies performed through rectus muscle splitting Incision.

Methods: Colostomy prolapse may present serious problems for patient care and stoma function6. Sigmoid loop colostomy was done for babies with High anorectal malformation (HARM) and Hirschsprung’s disease (HD) from Jan2012 to Dec2014 in two referral hospitals. All colostomies were sigmoid loop colostomies and done by a single surgeon through rectus muscle splitting incision. All patients were followed up for colostomy prolapse for at least 6 months.

Results: A total of 110 babies managed with colostomy during the study period. The patients comprised of 68 males and 42 females. High anorectal malformation accounted for 66 babies [males 48, females18] while Hirschsprung’s disease was the surgical indication in 44 [males20, females24]. The age at colostomy ranged from 1day to 4 years. A total of 32 complications were recorded in 25patients [29%]. There were 4 deaths [3.6%]. Early complications like Haemorrhage and septicaemia was seen 4 patients. Colostomy stenosis was observed in 3 cases requiring only dilatation. Colostomy prolapse was seen only in 3 patients [3.24%]. Skin excoriation was the commonest complication, noted in 10 patients. Failure to thrive secondary to colostomy diarrhoea was observed in 3 patients. Superficial wound dehiscence occurred in 3 babies. Urinary tract infection seen in 5 and Intestinal obstruction requiring laparotomy occurred in one baby.

Conclusions: Colostomy prolapse is very common after loop colostomies. Rectus muscle splitting incision for loop colostomies is safe and is associated with low incidence of colostomy prolapse.

Metrics

Metrics Loading ...

References

Lister J, Webster PJ, Mirza S. Colostomy complications in children. Practitioner. 1983;227(1376):229-37.

Mollitt DL, Malangoni MA, Ballantine TV, Grosfeld JL. Colostomy complications in children. An analysis of 146 cases. Arch Surg. 1980;115:455-8.

Rickwood AM, Hemlatha V, Brooman P. Closure colostomy in infants and children. Br J Surg. 1979;66;273-4.

Nour S, Beck J, Stringer MD. Colostomy complications in infants and children. Ann R Coll Engl. 1996;78(6):526-30.

Dobrenect RC. Revision and closure colostomy. Surg Clin North Am. 1991;7:193-201.

Krasna IH. A simple purse string suture technique for treatment of colostomy prolapse and intussusception. J Paed Surg. 1979;14(6):801-2.

Pena A. Management of anorectal malformation during the new-born period. World J Surg. 1993;17:385-92.

Chowdhary SK, Chalapathi G, Narasimhan KL, Samujh R, Mahajan JK, Menon P, et al. An audit of neonatal colostomy for high anorectal malformation: the developing world perspective. Pediatr Surg Int. 2004;20:111-3.

Al-salem AH, Grant C, Khawaja S. Colostomy complications in infants and children. Int Surg. 1992;77(3):164-6.

Decanniere D, Pector JC, Gernad A. Definitive colostomy and quality of life. Acta Chir Belg. 1987;87(6):355-7.

Hut'an M, Salapa M, Balaz P, Poticný V, Sokol R. Complications of colostomy-how to avoid them. Ozhl Chir. 1999;78(11):593-6.

Andivot T, Bail JP, Chio F, Juglard G, Topart P, Lozac'h P. Complications of colostomies. Follow-up study of 500 colostomised patients. Ann Chir. 1996;50(3):252-7.

Patwardhan N, Kiely EM, Drake DP, Spitz L, Pierro A. Colostomy for anorectal anomalies: high incidence of complications. J Pediatr Surg. 2001;36(5):795-8.

Oda O, Davies D, Colapinto K, Gerstle JT. Loop versus divided colostomy for management of anorectal malformations. J Prdiatr Surg. 2014;49(1):87-90.

Van den Hondel D, Sloots C, Meeussen C, Wijnen R. To split or not to split: colostomy complication for anorectal malformations or Hirschsprung’s disease: a single centre experience and a systematic review of the literature. Eur J Pediatr Surg. 2014;24(1):61-9.