Outcome of loop versus divided colostomy in the management of anorectal malformations
BACKGROUND: Colostomy is a common part of the management of high anorectal malformation (ARM) in the pediatric population. OBJECTIVE: To evaluate whether the type of colostomy (loop vs divided) has an impact on outcome in patients with ARM. DESIGN: A retrospective study. SETTING: King Faisal Special...
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| Format: | Article |
| Language: | English |
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King Faisal Specialist Hospital and Research Centre
2016-09-01
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| Series: | Annals of Saudi Medicine |
| Online Access: | https://www.annsaudimed.net/doi/full/10.5144/0256-4947.2016.352 |
| _version_ | 1818451280598663168 |
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| author | Osama Ibrahim Almosallam Ali Aseeri Saud Al Shanafey |
| author_facet | Osama Ibrahim Almosallam Ali Aseeri Saud Al Shanafey |
| author_sort | Osama Ibrahim Almosallam |
| collection | DOAJ |
| description | BACKGROUND: Colostomy is a common part of the management of high anorectal malformation (ARM) in the pediatric population. OBJECTIVE: To evaluate whether the type of colostomy (loop vs divided) has an impact on outcome in patients with ARM. DESIGN: A retrospective study. SETTING: King Faisal Specialist Hospital and Research Center, a tertiary care center. PATIENTS AND METHODS: All patients who were managed with colostomy for ARM and had definitive repair during the period of January 2000 to December 2014. Outcomes relative to the type of the colostomy were compared. MAIN OUTCOME MEASURES: Morbidities associated with each type of colostomy. RESULTS: There were 104 patients managed for ARM with colostomy as staged procedures, 63 males and 41 females. Patients had a colostomy at a median age of 6 days and were closed at a median of 11 months. Definitive repair was at a median age of 17 months. Type of fistula was 8 perineal, 21 rectovestibular, 35 rectourethral, 11 rectovesical and there were 16 without fistula and 13 cloaca anomalies. There were 55 loop and 49 divided colostomies. There were 91 descending/sigmoid and 13 transverse colostomies. Operative time for loop colostomy closure was shorter than with divided colo6stomy (76 minutes vs 94 minutes, P=.002). Three patients among the divided group had reversed orientation of the colostomy that had affected bowel preparations negatively prior to its repair. There was no differences in complications of creation and closure of loop and divided colostomies except in occurrence of skin excoriation. There was more skin excoriation with divided colostomy compared to loop colostomy (17 vs 10, P=.04). CONCLUSIONS: Loop colostomy has a shorter closure operative time and relatively fewer complications compared to the divided colostomy. Our data suggests that loop colostomy may be more favorable than divided colostomy for ARM patients. LIMITATIONS: Retrospective nature of the study and some colostomies performed at other hospitals. |
| first_indexed | 2024-12-14T21:04:41Z |
| format | Article |
| id | doaj.art-75bd6dd5929b4eba8f58cd17407965a2 |
| institution | Directory Open Access Journal |
| issn | 0256-4947 0975-4466 |
| language | English |
| last_indexed | 2024-12-14T21:04:41Z |
| publishDate | 2016-09-01 |
| publisher | King Faisal Specialist Hospital and Research Centre |
| record_format | Article |
| series | Annals of Saudi Medicine |
| spelling | doaj.art-75bd6dd5929b4eba8f58cd17407965a22022-12-21T22:47:30ZengKing Faisal Specialist Hospital and Research CentreAnnals of Saudi Medicine0256-49470975-44662016-09-0136535235510.5144/0256-4947.2016.352asm-5-352Outcome of loop versus divided colostomy in the management of anorectal malformationsOsama Ibrahim Almosallam0Ali Aseeri1Saud Al Shanafey2From the Department of Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi ArabiaFrom the Department of Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi ArabiaFrom the Department of Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi ArabiaBACKGROUND: Colostomy is a common part of the management of high anorectal malformation (ARM) in the pediatric population. OBJECTIVE: To evaluate whether the type of colostomy (loop vs divided) has an impact on outcome in patients with ARM. DESIGN: A retrospective study. SETTING: King Faisal Specialist Hospital and Research Center, a tertiary care center. PATIENTS AND METHODS: All patients who were managed with colostomy for ARM and had definitive repair during the period of January 2000 to December 2014. Outcomes relative to the type of the colostomy were compared. MAIN OUTCOME MEASURES: Morbidities associated with each type of colostomy. RESULTS: There were 104 patients managed for ARM with colostomy as staged procedures, 63 males and 41 females. Patients had a colostomy at a median age of 6 days and were closed at a median of 11 months. Definitive repair was at a median age of 17 months. Type of fistula was 8 perineal, 21 rectovestibular, 35 rectourethral, 11 rectovesical and there were 16 without fistula and 13 cloaca anomalies. There were 55 loop and 49 divided colostomies. There were 91 descending/sigmoid and 13 transverse colostomies. Operative time for loop colostomy closure was shorter than with divided colo6stomy (76 minutes vs 94 minutes, P=.002). Three patients among the divided group had reversed orientation of the colostomy that had affected bowel preparations negatively prior to its repair. There was no differences in complications of creation and closure of loop and divided colostomies except in occurrence of skin excoriation. There was more skin excoriation with divided colostomy compared to loop colostomy (17 vs 10, P=.04). CONCLUSIONS: Loop colostomy has a shorter closure operative time and relatively fewer complications compared to the divided colostomy. Our data suggests that loop colostomy may be more favorable than divided colostomy for ARM patients. LIMITATIONS: Retrospective nature of the study and some colostomies performed at other hospitals.https://www.annsaudimed.net/doi/full/10.5144/0256-4947.2016.352 |
| spellingShingle | Osama Ibrahim Almosallam Ali Aseeri Saud Al Shanafey Outcome of loop versus divided colostomy in the management of anorectal malformations Annals of Saudi Medicine |
| title | Outcome of loop versus divided colostomy in the management of anorectal malformations |
| title_full | Outcome of loop versus divided colostomy in the management of anorectal malformations |
| title_fullStr | Outcome of loop versus divided colostomy in the management of anorectal malformations |
| title_full_unstemmed | Outcome of loop versus divided colostomy in the management of anorectal malformations |
| title_short | Outcome of loop versus divided colostomy in the management of anorectal malformations |
| title_sort | outcome of loop versus divided colostomy in the management of anorectal malformations |
| url | https://www.annsaudimed.net/doi/full/10.5144/0256-4947.2016.352 |
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