Morbidity of Colostomy Closure in Children

Abstract

The care of colostomy remains a burden to the family while complications associated with its construction and closure can be tasking to the surgeon. The
aim of this study was to evaluate the outcome of colostomy closure in children in our setting.
A prospective review of 31 consecutive children undergoing colostomy closure in a 6
year period. There were 18 (58.1%) boys and 13 (41.9%) girls, aged 5 months 13 years (median 3 years). The median duration of colostomy was 16 months [range, 5 days -8
years]. Indications for colostomy were anorectal malformations 16(51.6%), Hirschsprung\'s disease 10(32.3%) and others 5 (16.1%). The site of colostomy was sigmoid colon 21, transverse colon 9 and caecum one. The type of colostomy was divided 18(58.1%) and loop12 (38.7%). Intraperitoneal and extraperitoneal closure was performed in 27(87.1%) and 4(12.9%) patients, respectively. Thirteen (41.9%) patients had 16 postoperative
complications; postoperative pyrexia 4 (12.9%), prolonged ileus 4 (12.9%), surgical site infection 2 (6.5%), septicaemia 2 (6.5%). Post operative complication rate was significantly
associated with the status of the surgeon (p < 0.05) and duration of surgery (p < 0.05). The median duration of hospital stay was 8 days [range: 5-35 days]. There was no
significant difference in hospital stay in patients with postoperative complication and thosewithout (p > 0.05). Morbidity following colostomy closure can be high, particularly when the procedure is performed by a junior trainee.

Keywords: Colostomy, closure, children,morbidity
This paper was presented before the 5th Annual Conference of Association of Paediatric Surgeons of Nigeria (APSON), Zaria, 14 November 2006
African Journal of Paediatric Surgery Vol. 4 (1) 2007: pp. 37-40