Forthcoming Issue 2 2024 Are end colostomies always contraindicated in anorectal malformations?

Main Article Content

G Brisighelli
A Theron
C Westgarth-Taylor
E Mapunda

Abstract

Objective: In our clinical setting, a three-staged approach is consistently employed for the management of patients with anorectal malformations (ARMs). The aim of our study is to evaluate the safety and feasibility of end-colostomies in specific subtypes of ARMs.


Methods: The medical records of babies born with an ARM treated between 01 January 2017 till 31 December 2022 were reviewed. Information regarding type of ARM, type of colostomy and complications at formation of colostomy, posterior sagittal ano-rectoplasty (PSARP), and colostomy closure was recorded.


Results: 194 patients were included: 137 patients had divided colostomies with distal mucus fistulas (DC) and 57 had end-colostomies (EC). Ninety-seven patients (50%) had perineal and vestibular fistulas: 40(42%) had DC and 57(58%) had EC. Post-colostomy formation, 8(20%) complications were recorded in the DC group 9(16%) and 8(20%) in the EC group(p-value:0.78). Wound sepsis presented in 6 patients with DC and 4 with EC(p-value:0.3). 16/85 patients (19%) that had a PSARP developed complications: 4/37(11%) with DC and 12/48(25%) with EC(p-value:0.16). Six(8%) complications occurred post 72 stoma reversal: 3 in DC and 3 in EC group.


Conclusion: In patients with rectoperineal and vestibular fistulas, where divided colostomies are not warranted, end colostomies provide a safe alternative.

Article Details

How to Cite
Forthcoming Issue 2 2024: Are end colostomies always contraindicated in anorectal malformations?. (2024). South African Journal of Child Health, 18(1), e1583. https://doi.org/10.7196/
Section
Research
Author Biographies

G Brisighelli, Division of Paediatric Surgery, Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Johannesburg Paediatric Colorectal Clinic, Department of Paediatric Surgery, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa

1 Division of Paediatric Surgery, Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

2 Johannesburg Paediatric Colorectal Clinic, Department of Paediatric Surgery, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa

A Theron, Division of Paediatric Surgery, Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Paediatric Surgery, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa

1 Division of Paediatric Surgery, Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

3 Department of Paediatric Surgery, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa

C Westgarth-Taylor, Johannesburg Paediatric Colorectal Clinic, Department of Paediatric Surgery, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa; Center for Colorectal and Pelvic Reconstruction, Nationwide Children's Hospital, Columbus, Ohio, United States

2 Johannesburg Paediatric Colorectal Clinic, Department of Paediatric Surgery, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa

4 Center for Colorectal and Pelvic Reconstruction, Nationwide Children's Hospital, Columbus, Ohio, United States

E Mapunda, Division of Paediatric Surgery, Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Department of Paediatric Surgery, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa

1 Division of Paediatric Surgery, Department of Surgery, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

3 Department of Paediatric Surgery, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa

How to Cite

Forthcoming Issue 2 2024: Are end colostomies always contraindicated in anorectal malformations?. (2024). South African Journal of Child Health, 18(1), e1583. https://doi.org/10.7196/

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