Abstract
Background: Colostomy formation and closure procedures are common operations, frequently be performed in patients with anorectal malformation. Collected information is lacking concerning the outcome of colostomy closure operations and the major factors influencing the outcome.
Objective: The authors examined the outcome and complications of colostomy closure in patients with anorectal malformation, and the major factors influencing the outcome.
Materials and methods: The study period was January 1997 through December 2007. A review of medical records from this period showed 259 cases of anorectal malformations (ARM). The records of one hundred and one patients from Songklanagarind Hospital were examined. The variables considered were first feeding time following the procedure, length of hospital stay and presence of complications. Influencing factors that might be related with these outcomes were identified.
Results: The data showed 107 colostomy closures. The median first feeding time was two days and median post operative hospital stay was five days. There were 13 cases (12.2%) of acute complications, of which the most common was wound infection (four cases, 3.7%) and 16 cases of late complication, most of which were fecal impaction (eight cases, 7.5%). Acute post-operative complications were more likely in patients with co-morbidity prior to surgery (p-value 0.088) and in transverse-end colostomies (p-value 0.004), and with an interval between colostomy formation and closure less than four months or more than eight months (p-value 0.010). Hospital stay was longer in patients with transverse-end colostomy (p-value 0.051), Down syndrome (p-value 0.009) and acute complications (p-value <0.001).
Conclusion: Many variables influenced the outcome of colostomy closure, most commonly co-morbidity prior to surgery, transverse-end colostomy, Down syndrome, and longer or shorter than normal interval between colostomy formation and closure.