SHORT TERM OUTCOME OF DIVERSION LOOP COLOSTOMY IN CHILDREN OF ANORECTAL MALFORMATION.

Abstract

Purpose: Colostomy for patients with anorectal malformations decompresses an obstructed colon, avoids fecal contamination of the urinary tract, and protects a future perineal operation. The procedure is associated with several signicant complications. Objective: To study relation of various demographic factors, clinical features, complications and patient related factors with outcomes. Methods-All necessary data of these 50 patients were obtained from case sheets and attendants of patients admitted in SNCU, NICU and wards of department of paediatrics and surgery. All the details (demographic, patients related, surgery) of patient was lled in predesigned structured proforma. Results- More than half of babies were males (68%). The male to female ratio was 2.1:1. The mean weight at post-operative 7 days was 4.74±0.21 kgs which increased to 5.19±0.41 kgs at post-operative 1 month, 5.73±0.88 kgs at post-operative 2 months and 6.28±0.6 kgs at post op 3 months. There was signicant (p=0.001) increase in weight from post-operative 7 days to postoperative 1 month, 2 months and 3 months. Peri stomal skin excoriation was seen in 8% at post-operative 7 day, 14% at postoperative 1 month, 12% at 2 months and 4% at 3 months. Stomal prolapse was seen in 2% patients at post-operative 7 days and in 4% patients at 1 month & 2 months and became nil at 3 months post-operatively. There was signicant (p=0.001) difference in weight gain from 7 days to 3 months post-operative between groups of age <30 days (1.67±0.33 kgs) and ≥30 days (1.08±0.65 kgs). Conclusion- Minimal post-operative complications of diversion loop colostomy in children of anorectal malformation and hence we can conclude that loop colostomy is safe in patients with anorectal malformations. we recommend, a study with a large sample size and longer duration of follow up, needs to be done to have a more effective and rationale conclusion.