COLOSTOMY RELATED MORBIDITY AND MORTALITY IN NEONATES WITH ANORECTAL MALFORMATION
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2016, Vol 5, Issue 68
Abstract
BACKGROUND Colostomy is a life-saving procedure in newborns with high/intermediate Anorectal Malformations (ARM). However, the procedure maybe attended by complications particularly in resource limited settings. AIM This study analyses the morbidity and mortality related to colostomy formation in neonates with ARM at tertiary care centre. SETTINGS AND DESIGN Department of Paediatric Surgery, Gandhi Medical College, Bhopal. A retrospective evaluation. METHOD Neonates who underwent colostomy for high or intermediate ARM in two year duration were included in the study. Patients in whom colostomy was done for reason other than ARM were excluded from the study. RESULT 124 patients with ARM reported to our institute in two years (January 2013-January 2015) duration. There were 72 male and 52 female neonates with ARM of age range between 1-4 days and weighing 1.5-2.6 kg. 60 patients had low anomaly and were treated with anoplasty while 64 had high/intermediate anomaly and were managed with colostomy. 10 patients underwent transverse loop colostomy while 54 had sigmoid loop colostomy. 55 patients developed complications related to colostomy, which included skin excoriation (62%), stoma prolapse (23.4%), bleeding (12.5%), obstruction (4.68%), wound infection (9.37%), and retraction (6.25%). Mortality was in 12.5% cases. CONCLUSIONS There is substantial morbidity associated with colostomy formation in neonates with ARM at our limited resource centre. Refinements in surgical technique along with comprehensive postoperative care may facilitate to reduce these complications following colostomy in ARM.
Authors and Affiliations
Dhirendra , Swati , Kuldeep , Abhishek
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