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Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer

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Temporary umbilical loop colostomy for anorectal malformations.

Yoshinori Hamada¹, Kohei Takada, Yusuke Nakamura

¹Division of Pediatric Surgery, Kansai Medical University, 2-3-1 Shinmachi, Hirakata, Osaka, 573-1191, Japan. hamaday@hirakata.kmu.ac.jp

Pediatric Surgery International

|September 25, 2012

Summary

This summary is machine-generated.

Temporal umbilical loop colostomy (TULC) is a safe and cosmetically pleasing option for temporary colostomy in infants with anorectal malformations (ARMs). This technique offers excellent wound healing and minimal complications, making the umbilicus a viable alternative stoma site.

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Murine Distal Colostomy, A Novel Model of Diversion Colitis in C57BL/6 Mice

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Area of Science:

Pediatric Surgery
Surgical Innovation
Anorectal Malformations

Background:

Transumbilical surgical procedures are recognized for their safety and cosmetic benefits in pediatric patients.
Umbilical loop colostomies have been used for Hirschsprung's disease but not previously for anorectal malformations (ARMs).

Purpose of the Study:

To evaluate the feasibility and cosmetic outcomes of temporal umbilical loop colostomy (TULC) in infants diagnosed with anorectal malformations.
To establish the umbilicus as a potential alternative stoma site for temporary colostomy in this patient population.

Main Methods:

A standardized surgical technique involving a circumferential umbilical incision, ligation of umbilical structures, and creation of a double-barreled loop colostomy with a high chimney.
The stoma was matured by longitudinal opening and eversion without skin suturing, followed by division at 7 days and closure 2-3 months post-anorectoplasty.
Final wound closure aimed to create a deep umbilicus.

Main Results:

Successful TULCs were performed in seven infants with rectourethral bulbar or rectovestibular fistulas.
One case of postoperative mucosal prolapse was noted; however, no wound infections or spontaneous umbilical ring narrowing occurred.
Minimal skin issues and effective stoma management were observed, with excellent umbilical wound healing post-closure.

Conclusions:

Temporal umbilical loop colostomy is a feasible and cosmetically advantageous procedure for temporary stoma creation in infants with intermediate-type anorectal malformations undergoing non-abdominal anorectoplasty.
The umbilicus serves as a suitable alternative stoma site, demonstrating good outcomes and patient tolerance.