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"Colostomy"

Original Articles

[English]
Stomal Complications in Children
Joong Jai Park, Joo Hong Lee, Jong Do Jung, Young Cheol Choi, Woo Shik Chung, Si Youl Jun
J Korean Assoc Pediatr Surg 2002;8(1):11-15.   Published online June 30, 2002
DOI: https://doi.org/10.13029/jkaps.2002.8.1.11

This is a 20 year analysis of the problems associated with enterostomy formation, and closure. Forty-three stomas were established in 43 patients: 23 for anorectal malformations, 11 for Hirschsprung's diseases, 4 for necrotizing enterocolitis, 3 for multiple ileal atresias, 1 for volvulus neonatorum with perforation, and 1 for diaphragmatic hernia with colon perforation. Thirty boys and 13 girls were included (mean age 4.8 months). Stoma complications were encountered in 13 patients (30.2 %): stomal prolapse, stenosis, obstruction, paracolic hernia, retraction, dysfunction, and skin excoriation. Four patients (9.3 %) required stomal revision. Occurrence of complications was not related to age and primary disease, but sigmoid colostomy showed lower complication rate than transverse colostomy (20.0 % vs 42.9 %, p<0.05). There were five deaths but, only one (2.3 %) was directly related to the enterostomy complication. Twenty-one stomas were closed in our hospital and complications occurred in seven patients (33.3 %). The most common complication was wound sepsis in 5 children. In conclusion, because the significant morbidity of stomal formation still exists, refinements of the surgical technique seem to be required. Sigmoid loop colostomy is preferred whenever possible.

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[English]
Purse-String Closure for Stoma Reversal in Pediatric Patients
Koo, Eun-jung , Jung, Eunyoung
Adv Pediatr Surg 2023;29(1):9-16.
DOI: https://doi.org/10.13029/aps.2023.29.1.9
Purpose
Temporary stoma formation is a common procedure in pediatric surgery. Surgical site infection after stoma reversal surgery is a common complication, and the cosmetic effect after skin suturing is reduced. Purse-string closure has been suggested for stoma reversal, preventing surgical site infections and providing better cosmesis. Positive results have been reported abroad for the purse-string closure technique for stoma reversal in pediatric patients; however, no cases have been reported in Korea. Therefore, we aimed to investigate the outcomes of purse-string closure for stoma reversal in pediatric patients.
Methods
From October 2018 to September 2022, all pediatric patients who underwent stoma reversal at the Department of Pediatric Surgery were included. The electronic medical records of the patients were retrospectively reviewed. The following variables were analyzed: perinatal data including gestational age, sex, birth weight, Apgar score, and types of delivery; preoperative conditions including total parental nutrition, steroid use, and tracheal intubation; operational data such as diagnosis, types of stoma, age, body weight, skin closure methods and operation time; and postoperative data such as surgical site infection, transfusion, days until extubation, and start of enteral feeding. The serial wound healing process after purse-string closure was documented using photographs.
Results
Thirty-seven patients underwent stoma reversal surgery, 14 underwent purse-string closure, and 23 underwent conventional lineal closure. No surgical site infection occurred in the purse-string group and four cases of surgical site infection occurred in the conventional liner group. However, there were no statistically significant differences between both groups (p=0.276).
Conclusion
No surgical wound infection was found in pediatric patients who underwent purse-string closure for stoma reversal, and the cosmetic effect was promising. However, no statistically significant difference was found between the purse-string closure and conventional linear closure groups. Further multicenter studies involving a larger sample size are needed to determine statistical significance.
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