Comparison of divided versus loop sigmoid colostomy in the management of anorectal malformation
Iranian Journal of Pediatric Surgery,
Vol. 5 No. 2 (2019),
4 February 2020
Introduction: Anorectal malformation (ARM) is a birth defect of the digestive tract in which the anus and rectum are not normally developed. Surgical procedure such as colostomy (loop or divided) is suggested as the initial treatment for high variety ARM. Our objective was to compare frequency of stoma related complications of loop sigmoid colostomy versus divided sigmoid colostomy for high variety anorectal malformations.
Materials and Methods: A randomized controlled trial was carried out at children’s hospital and the institute of child health Lahore. A total of 180 patients were divided into two groups randomly using lottery method loop sigmoid colostomy (group-A) and divided sigmoid colostomy (group-B). After surgeries patients were followed weekly up till 4 weeks. Stoma related complications were noted.
Results: The mean age in group A and group B were 3.22 ± 1.26 days and 3.36 ± 0.97 days respectively. In group A there were 77 male & 13 were female, in group B there were 67 male & 23 female patients. In group A 24.5% patients had complications: 3.4% patients had retraction, 11.1% had prolapse, 2.2% had Obstruction, parastomal hernia was seen in 5.6%, stoma necrosis were seen in 2.2%. In group B 20% patients had different complications: 2.2% patients had retraction, 2.2% had prolapse, 5.6% had obstruction, parastomal hernia were seen in 2.2% and stoma necrosis were seen in 7.8%. The complications in group A were higher when compared to group B but were not significant, p-value > 0.05.
Conclusion: Divided sigmoid colostomy can be adopted to avoid stoma related complications in future.
- Anorectal malformation
- Divided colostomy
- Loop colostomy
How to Cite
Beudeker N, Broadis E, Borgstein E, et al: The hidden mortality of imperforate anus. Afr J Paediatr Surg 2013;10(4):302-6.
Zwink N, Jenetzky E, Brenner H: Parental risk factors and anorectal malformations: systematic review and meta-analysis. Orphanet J Rare Dis 2011;6:25-42.
Mirza B, Ijaz L, Saleem M, et al: Anorectal malformations in neonates. Afr J Paediat Surg 2011;8(2):151-4.
Iwai N, Fumino S: Surgical treatment of Anorectal Malformations. Surg Today 2013;43:955-62.
Meier DE, Hesse AA: Anorectal malformations. Paediatr Surg: A Comprehensive Text for Africa Seattle: Global Help 2011:455-60.
Oda O, Davies D, Colapinto K, et al: Loop versus divided colostomy for the management of anorectal malformations. J Pediatr Surg 2014;49(1):87-90.
Holschneider A, Hutson J, Peña A, et al: Preliminary report on the International Conference for the Development of Standards for the Treatment of Anorectal Malformations. J Pediatr Surg 2005;40(10):1521-6.
Levitt MA, Peña A: Anorectal malformations. Orphanet J rare Dis. 2007;2(1):33: DOI: 10.1186/750-72-2-33.
Goldblum JR: Rosai and Ackerman's Surgical Pathology E-Book. Elsevier Health Sciences 2017.
Chirdan LB, Uba FA, Ameh EA, et al: Colostomy for high anorectal malformation: an evaluation of morbidity and mortality in a developing country. Pediatr Surg Int 2008;24(4):407-10.
Shrivastava D, Jain S, Kuldeep AC, et al: Colostomy related morbidity and mortality in neonates with anorectal malformation. J. Evolution Med. Dent. Sci 2016;5(68):4882-4.
Pena A, Migotto-Krieger M, Levitt MA: Colostomy in anorectal malformations: a procedure with serious but preventable complications. J Pediatr Surg 2006;41(4):748-56.
Patwardhan N, Kiely EM, Drake DP, et al: Colostomy for anorectal anomalies: High incidence of complications. J Pediatr Surg 2001;36(5):795-8.
Nasar GN: Indications & Complications of Colostomy in Children. Annals of Punjab Medical College (APMC) 2017;11(2):110-2.
Yang L, Tang ST, Li S, et al: Two-stage laparoscopic approaches for high anorectal malformation: Transumbilical colostomy and anorectoplasty. Journal of pediatric surgery 2014;49(11):1631-4.
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