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An Analysis of 146 Cases

Daniel L. Mollitt, MD; Mark A. Malangoni, MD; Thomas V. N. Ballantine, MD; Jay L. Grosfeld, MD

Arch Surg. 1980;115(4):455-458.

Abstract
• This report analyzes the course of 146 pediatric patients with colostomies in reference to problems with colostomy formation, management, and subsequent closure. Colostomy was performed predominantly for Hirschsprung's disease (70 cases) and imperforate anus (46 cases). A transverse colostomy was done in 120 patients (82%), and a sigmoid colostomy in the remaining patients. Loop colostomies were five times more frequent than divided colostomies. Early major complications occurred in 24 patients (16%). Stomal complications occurred in 69 patients and were more frequent after loop colostomies. Colostomy revision was required in 24 cases. Sigmoid colostomy had a significantly lower complication rate (P <.01). One hundred nine patients underwent colostomy closure. Major complications occurred in 16 cases (15%). There were no deaths related to colostomy closure. The use of a sigmoid colostomy when possible and close attention to technical details, principles of stomal care, and proper parental instruction should minimize morbidity.

(Arch Surg 115:455-458, 1980)

Author Affiliations
From the Section of Pediatric Surgery, Department of Surgery, Indiana University School of Medicine, and the James Whitcomb Riley Hospital for Children, Indianapolis.

Footnotes
Read before the 87th annual meeting of the Western Surgical Association, Colorado Springs, Colo, Nov 13, 1979.

Reprint requests to James Whitcomb Riley Hospital for Children, Room K-21, 1100 W Michigan St, Indianapolis, IN 46223 (Dr Grosfeld).

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