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Colostomy for anorectal anomalies: high incidence of complications.
J Pediatr Surg. 2001 May; 36(5):795-8.JP

Abstract

PURPOSE

The aim of this study was to characterize the type and incidence of complications related to colostomy formation in newborn infants with anorectal anomalies.

METHODS

The authors reviewed a 5-year (1994 to 1999) experience of a single institution in the management of neonates with high and intermediate anorectal anomalies who required colostomy at birth. Patients with colostomy still in place have been excluded from the study to maximize the chances of detecting colostomy-related complications.

RESULTS

There were 80 neonates with anorectal malformations, of whom, 49 (31 boys and 18 girls) were included in the study. The site of colostomy was sigmoid colon (n = 32), transverse colon (n = 7), and descending colon (n = 10). Thirty-nine colostomies were loop, and the remaining 7 were divided. The median birth weight was 2.96 kg (range, 1.46 to 3.88). The age at colostomy formation was 2 days (range, 1 to 210). Mechanical complications related to colostomy formation were observed in 16 infants (32%) with 3 infants having more than 1 mechanical complication. These included prolapse in 8 (50%), intestinal obstruction (adhesions, intussusception, and volvulus) in 7 (44%), and skin dehiscence in 3 (19%). One neonate had necrotizing enterocolitis (NEC) after colostomy formation. Urinary tract infection was observed after colostomy in 14 infants (29%). The incidence of urinary tract infection was not higher in infants who had loop colostomy (11 of 39, 28%) compared with infants who had divided colostomy (3 of 10, 30%). There were no differences in the incidence of colostomy-related complications and urinary tract infection between male and female infants. There were no deaths in this series.

CONCLUSIONS

Formation of colostomy for anorectal anomalies should not be considered a minor procedure. In our experience the incidence of complications after colostomy formation is high. The incidence of urinary tract infections does not seem to be affected by the type of colostomy performed.

Authors+Show Affiliations

Patwardhan N
Department of Paediatric Surgery, The Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust, University College London, London, England, UK.
Kiely EM
No affiliation info available
Drake DP
No affiliation info available
Spitz L
No affiliation info available
Pierro A
No affiliation info available

MeSH

Age FactorsAnal CanalAnus, ImperforateBiomechanical PhenomenaBirth WeightColostomyFemaleHumansIncidenceInfant, NewbornIntestinal ObstructionMaleRectal FistulaRectal ProlapseRectumRetrospective StudiesTreatment OutcomeUrethral DiseasesUrinary Bladder FistulaUrinary FistulaUrinary Tract Infections

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11329592

Citation

Patwardhan, N, et al. "Colostomy for Anorectal Anomalies: High Incidence of Complications." Journal of Pediatric Surgery, vol. 36, no. 5, 2001, pp. 795-8.
Patwardhan N, Kiely EM, Drake DP, et al. Colostomy for anorectal anomalies: high incidence of complications. J Pediatr Surg. 2001;36(5):795-8.
Patwardhan, N., Kiely, E. M., Drake, D. P., Spitz, L., & Pierro, A. (2001). Colostomy for anorectal anomalies: high incidence of complications. Journal of Pediatric Surgery, 36(5), 795-8.
Patwardhan N, et al. Colostomy for Anorectal Anomalies: High Incidence of Complications. J Pediatr Surg. 2001;36(5):795-8. PubMed PMID: 11329592.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Colostomy for anorectal anomalies: high incidence of complications. AU - Patwardhan,N, AU - Kiely,E M, AU - Drake,D P, AU - Spitz,L, AU - Pierro,A, PY - 2001/5/1/pubmed PY - 2001/7/13/medline PY - 2001/5/1/entrez SP - 795 EP - 8 JF - Journal of pediatric surgery JO - J Pediatr Surg VL - 36 IS - 5 N2 - PURPOSE: The aim of this study was to characterize the type and incidence of complications related to colostomy formation in newborn infants with anorectal anomalies. METHODS: The authors reviewed a 5-year (1994 to 1999) experience of a single institution in the management of neonates with high and intermediate anorectal anomalies who required colostomy at birth. Patients with colostomy still in place have been excluded from the study to maximize the chances of detecting colostomy-related complications. RESULTS: There were 80 neonates with anorectal malformations, of whom, 49 (31 boys and 18 girls) were included in the study. The site of colostomy was sigmoid colon (n = 32), transverse colon (n = 7), and descending colon (n = 10). Thirty-nine colostomies were loop, and the remaining 7 were divided. The median birth weight was 2.96 kg (range, 1.46 to 3.88). The age at colostomy formation was 2 days (range, 1 to 210). Mechanical complications related to colostomy formation were observed in 16 infants (32%) with 3 infants having more than 1 mechanical complication. These included prolapse in 8 (50%), intestinal obstruction (adhesions, intussusception, and volvulus) in 7 (44%), and skin dehiscence in 3 (19%). One neonate had necrotizing enterocolitis (NEC) after colostomy formation. Urinary tract infection was observed after colostomy in 14 infants (29%). The incidence of urinary tract infection was not higher in infants who had loop colostomy (11 of 39, 28%) compared with infants who had divided colostomy (3 of 10, 30%). There were no differences in the incidence of colostomy-related complications and urinary tract infection between male and female infants. There were no deaths in this series. CONCLUSIONS: Formation of colostomy for anorectal anomalies should not be considered a minor procedure. In our experience the incidence of complications after colostomy formation is high. The incidence of urinary tract infections does not seem to be affected by the type of colostomy performed. SN - 0022-3468 UR - https://www.unboundmedicine.com/medline/citation/11329592/Colostomy_for_anorectal_anomalies:_high_incidence_of_complications_ DB - PRIME DP - Unbound Medicine ER -