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[The complications of intestinal stoma in children]
S V Minaev1, N I Bykov2, A V Isaeva1
1Stavropol State Medical University, Russian Federation.
Insights
This study on pediatric intestinal stoma complications found that proper care and specific products significantly reduce issues. Implementing these measures is key to successful stoma function in children.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Clinical Research
Background:
- Intestinal stomas are surgically created openings to divert intestinal contents.
- Complications associated with intestinal stomas in children can significantly impact patient outcomes.
- Effective management strategies are crucial for minimizing stoma-related morbidities.
Purpose of the Study:
- To investigate the incidence and types of intestinal stoma complications in pediatric patients.
- To identify and develop measures for reducing the occurrence of these complications.
- To improve the overall success of intestinal stoma function in children.
Main Methods:
- A cohort of 152 children with congenital or acquired gastrointestinal conditions requiring intestinal stoma surgery was studied.
- Data collected included patient demographics, underlying pathologies (e.g., atresia, necrotizing enterocolitis), stoma type (ileostomy, colostomy), and functional duration.
- Complications were categorized as early (dehiscence, necrosis) and late (dermatitis, stenosis).
Main Results:
- Early complications observed included stoma dehiscence (2.6%), evagination (4.6%), and marginal necrosis (1.3%).
- Late complications comprised dermatitis (23.1%), stenosis (5.9%), and stoma evagination (7.9%).
- The use of specific colostomy bags and skin care products demonstrated a significant reduction (p<0.01) in complications during inpatient treatment.
Conclusions:
- Optimal intestinal stoma function in pediatric patients relies on both surgical technique and diligent post-operative care.
- Timely identification and management of stoma-related complications are essential.
- The study highlights the effectiveness of targeted interventions, such as specialized ostomy products, in mitigating complications.
Aim:
To investigate the complications of intestinal stoma in children and to develop measures for decrease of their incidence.
Material And Methods:
The study included 152 children with congenital and acquired gastrointestinal pathology requiring surgical treatment with the imposition of intestinal stoma. Atresia of intestinal tube was observed in 28 (18.4%) children, meconium ileus - in 10 (6.6%) cases, Hirschsprung's disease - in 11 (7.2%)cases, anorectal malformations - in 39 (25.7%) cases, multiple malformations - in 11 (7.2%) patients, necrotic enterocolitis - in 56 (36.8%) patients, other reasons - in 7 (4.6%) cases. The average age of patients was 12,3±7,2 days. There were 93 (61.2%) boys and 59 (38.8%) girls. Ileostomy, ileocolostomy and colostomy were made in 37 (24.3%), 46 (30.3%) and 69 (45.4%) cases respectively. Time of intestinal stoma function was 18-217 days.
Results:
Early complications were dehiscence in the area of stoma in 4 (2.6%) children, evagination in 7 (4.6%) patients, marginal necrosis of stoma in 2 (1.3%) cases, retraction of stomy into abdominal cavity in 1 (0.6%) child and abdominal skin maceration in 8 (5.2%) patients. Remote complications included dermatitis around stomy in 35 (23.1%) children, stenosis of stoma in 9 (5.9%) cases, evagination of stoma in 12 (7.9%) patients. Also, 5 patients were unable to use the colostomy bag due to vicious overlaying of intestinal stoma. Using the colostomy bags «Coloplast» and skin care products around the stoma significantly reduced (p<0.01) the number of complications at inpatient stage of treatment.
Conclusion:
Successful function of stoma depends on not only technical aspects but also obligatory care performance with timely correction of complications.
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