Morbidity and mortality of colostomy and its closure in children.
BACKGROUND
This study evaluated the complications of colostomy and its closure in infants and children.


METHODS
One hundred forty-six colostomies were performed in 86 neonates, 23 infants, and 37 children older than 1 year. These children underwent colostomies for anorectal malformation (84), Hirschsprung's disease (47), and other miscellaneous (15) conditions like colonic atresia, volvulus, rectal tuberculosis, traumatic rectal perforation, and intestinal obstruction caused by ascariasis.


RESULTS
Of these, 17 (11.6%) had early complications, and 80 (69.8%) had stomal complications. Three patients died, but only 1 death was directly related to colostomy. Colostomy prolapse, peristomal excoriation, and malnutrition were the major complications. The complications were not dependant on the children's age or primary indication. Sigmoid colostomy had a lower malnutrition rate than transverse colostomy (34.9% v 16.9% P =.009). Among the 56 children who underwent colostomy closure, major complications include death (1.8%), anastomotic leak (7.1%), and wound infection (12.6%).


CONCLUSIONS
A divided sigmoid colostomy should be performed whenever possible. Proper stomal care, regular nutritional assessment, and early closure of the colostomy would minimize morbidity and mortality of colostomy and its closure.
Chandramouli
B
B
Department of General Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
Srinivasan
K
K
Jagdish
S
S
Ananthakrishnan
N
N
D000015:Abnormalities, Multiple / Q000401:mortality; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000601:surgery*; D012809:Colon, Sigmoid / Q000601:surgery; D003125:Colostomy / Q000009:adverse effects* / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data; D005260:Female; D006547:Hernia / Q000453:epidemiology / Q000209:etiology; D059685:Herniorrhaphy; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D007410:Intestinal Diseases / Q000453:epidemiology / Q000209:etiology; D007415:Intestinal Obstruction / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D008297:Male; D044342:Malnutrition / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000401:mortality; D011391:Prolapse; D012189:Retrospective Studies; D018805:Sepsis / Q000209:etiology / Q000401:mortality; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology; D000267:Tissue Adhesions / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome