The Outcome Of Loop Versus Devine's Colostomies In Management Of High Anorectal Malformations
Abstract:
BACKGROUND: Colostomy is generally component of the neonatal population's management of high anorectal malformation (ARM). OBJECTIVES: To evaluate the outcome of loop colostomies in management of high ARM patients and compare it with Devine's colostomies outcome. DESIGN: A case control retrospective prospective study. SETTING: pediatric surgery department, Zagazig university hospital. PATIENTS AND METHODS: All patients who were managed with colostomy for high ARM and had definitive repair during the period of January 2017 to January 2019. Outcomes relative to the type of the colostomy were compared. RESULTS: There were 30 patients managed for high ARM with colostomy as staged procedures, 17 males and 13 females. Patients had a colostomy at a median age of 2 days and were closed at a median of 9 months. Presence of fistula was in 18 patients. There were 15 loop and 15 divided colostomies. Operative time for loop colostomy creation was shorter than with divided colostomy (35 minutes vs 60 minutes, P=0.04). Operative time for loop colostomy closure was shorter than with divided colostomy (47 minutes vs 79 minutes, P=0.032).
There was no differences in complications of creation of loop and divided colostomies, There was differences in complications of closure (p= 0.033).
CONCLUSIONS: Loop colostomy has a shorter operating time of formation and closure and comparatively less complications compared to the separated colostomy. Our information suggest that loop colostomy may be more beneficial for high ARM patients than Devin's colostomy.