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Published on: November 4, 2010

Morbidity and mortality of colostomy and its closure in children

B Chandramouli1, K Srinivasan, S Jagdish

  • 1Department of General Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.

Journal of Pediatric Surgery
|April 6, 2004
PubMed

Insights

Complications from colostomy (intestinal diversion) and its closure in children are common, with stomal issues like prolapse and malnutrition being most frequent. Sigmoid colostomy and proper stomal care can reduce risks.

Area of Science:

  • Pediatric Surgery
  • Gastrointestinal Surgery

Background:

  • Colostomy is a surgical procedure to divert intestinal contents.
  • Complications associated with colostomy and its subsequent closure in pediatric patients require thorough evaluation.

Purpose of the Study:

  • To assess the incidence and types of complications following colostomy and colostomy closure in infants and children.
  • To identify factors influencing these complications and outcomes.

Main Methods:

  • Retrospective analysis of 146 colostomies performed in neonates, infants, and children.
  • Indications included anorectal malformation, Hirschsprung's disease, and other conditions.
  • Evaluation of early, stomal, and closure-related complications.

Main Results:

  • High rates of stomal complications (69.8%) and early complications (11.6%) were observed.
  • Major stomal issues included prolapse, peristomal excoriation, and malnutrition.
  • Sigmoid colostomy was associated with a lower malnutrition rate compared to transverse colostomy (16.9% vs. 34.9%).
  • Colostomy closure had a mortality rate of 1.8%, with anastomotic leak (7.1%) and wound infection (12.6%) as significant complications.

Conclusions:

  • Divided sigmoid colostomy is recommended when feasible.
  • Minimizing morbidity and mortality necessitates diligent stomal care, nutritional monitoring, and timely colostomy closure.
Abstract

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