Background: The aim of the study was the analysis of the incidence and type of complications related to the formation and closure of colostomies in children with anorectal malformations (ARM).
Material and methods: Between 1992 and 2009, the author treated 95 children with ARMs. In 59 of them (62.1%) colostomies were opened prior to the definitive surgery.
Results: The median age of colostomy creation was 2 days of life (range, 1 day to 18 months). In 51 children (86.4%) this was a divided colostomy, in 5 (8.5%) a loop colostomy and in 3 instances (5.1%) a permanent one-stoma colostomy. In 51 patients (86.4%) the colostomy was localized at the descending/sigmoid colon, in 5 (8.5%) in the left transverse colon and in 3 (5.1%) in the rectum. The median duration of the colostomy was 7.8 weeks (range, 3 to 12 weeks). Complications related to the colostomy were observed in 14 children (14/59 - 23.7%). These included: retraction and stenosis of one of the stomas - in 4, skin dehiscence - in 3, bowel prolapse - in 3 cases, leak of anastomosis after closure of divided colostomy - in 2, intestinal adhesive obstruction - in one and granulomas around stomas - in one patient.
Conclusions: A divided colostomy is in author’s opinion more advantageous, when compared with loop colostomy in maintaining stomas, in performing the distal colostography, as well as having a lower incidence of prolapse and urinary tract infections. A critical analysis showed that the majority of complications related to the colostomy were caused by technical error and in author’s opinion can be mostly prevented.
Chirurgia Polska 2010, 12, 1, 18-25