Muscle splitting sigmoid loop colostomy: a viable option to prevent colostomy prolapse

Abstract

Background: The purpose the study was to assess the incidence of Colostomy prolapse with sigmoid loop colostomies performed through rectus muscle splitting Incision.Methods: Colostomy prolapse may present serious problems for patient care and stoma function6. Sigmoid loop colostomy was done for babies with High anorectal malformation (HARM) and Hirschsprung’s disease (HD) from Jan2012 to Dec2014 in two referral hospitals. All colostomies were sigmoid loop colostomies and done by a single surgeon through rectus muscle splitting incision. All patients were followed up for colostomy prolapse for at least 6 months.Results: A total of 110 babies managed with colostomy during the study period. The patients comprised of 68 males and 42 females. High anorectal malformation accounted for 66 babies [males 48, females18] while Hirschsprung’s disease was the surgical indication in 44 [males20, females24]. The age at colostomy ranged from 1day to 4 years. A total of 32 complications were recorded in 25patients [29%]. There were 4 deaths [3.6%]. Early complications like Haemorrhage and septicaemia was seen 4 patients. Colostomy stenosis was observed in 3 cases requiring only dilatation. Colostomy prolapse was seen only in 3 patients [3.24%]. Skin excoriation was the commonest complication, noted in 10 patients. Failure to thrive secondary to colostomy diarrhoea was observed in 3 patients. Superficial wound dehiscence occurred in 3 babies. Urinary tract infection seen in 5 and Intestinal obstruction requiring laparotomy occurred in one baby.Conclusions: Colostomy prolapse is very common after loop colostomies. Rectus muscle splitting incision for loop colostomies is safe and is associated with low incidence of colostomy prolapse.