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By Alejandro Peñarrieta Daher Pediatric Surgeon / Neonatal Surgeon
Debasish Bijoykrishna Banerjee, Hasanthi Vithana, Shilpa Sharma, Thomas Tat Ming Tsang
Newborns undergoing surgery for necrotizing enterocolitis (NEC) often require a stoma. Currently, there is no consensus regarding the best time for stoma closure (SC). Our aim was to determine the outcomes of early versus late closure. METHODS: Retrospective analysis of patients who underwent SC following stoma formation for NEC between Jan 2009 and July 2015 was done. Early (EC) versus late closure (LC) was defined as less than 10 weeks versus at or after 10 weeks of stoma formation...
July 2017: Pediatric Surgery International
Lindsay J Talbot, Robert D Sinyard, Kristy L Rialon, Brian R Englum, Elizabeth T Tracy, Henry E Rice, Obinna O Adibe
PURPOSE: Neonates after emergent enterostomy creation frequently require reversal at low weight because of complications including cholestasis, dehydration, dumping, failure to thrive, and failure to achieve enteral independence. We investigated whether stoma reversal at low weight (< 2.5kg) is associated with poor surgical outcomes. METHODS: Patients who underwent enterostomy reversal from 2005 to 2013 at less than 6months old were identified in our institutional database...
January 2017: Journal of Pediatric Surgery
Anne K Danielsen, Jennifer Park, Jens E Jansen, David Bock, Stefan Skullman, Anette Wedin, Adiela Correa Marinez, Eva Haglind, Eva Angenete, Jacob Rosenberg
OBJECTIVE: The objective was to study morbidity and mortality associated with early closure (8-13 days) of a temporary stoma compared with standard procedure (closure after > 12 weeks) after rectal resection for cancer. BACKGROUND: A temporary ileostomy may reduce the risk of pelvic sepsis after anastomotic dehiscence. However, the temporary ileostomy is afflicted with complications and requires a second surgical procedure (closure) with its own complications...
February 2017: Annals of Surgery
K Siddique, G Prud'Homme, N Samuel, K Avil-Griffiths, T Offori
INTRODUCTION: Creation of gastrointestinal stomas is a common colorectal procedure associated with early or late complications, some of which demand advanced technical skills and expertise for optimal management. CASE HISTORY: A 63-year-old male underwent a defunctioning loop colostomy for locally advanced rectal cancer with liver metastasis. Three months later, he had developed a skinfold over his stoma that resulted in a horizontal skin crease traversing through the stoma, causing the stoma to 'sink' leading to obliteration of the stomal opening...
May 2016: Annals of the Royal College of Surgeons of England
K Boyd, N Copertino, A L Lambrianides
No abstract text is available yet for this article.
January 2016: Annals of the Royal College of Surgeons of England
M V Phadke, L H Stocks, Y G Phadke
BACKGROUND: Brooke ileostomy and colostomy are associated with infection in the stomal and/or main wounds, leading to complications. The source of infection is feces from the open lumen. The objective of the present study was to find a way to prevent infection and subsequent complications. It was started in 1986 by serendipity after discovery that if wound contamination from intestinal contents is stopped in the immediate postoperative period, by a complete small/large intestinal obstruction, infection and complications are prevented...
September 2007: Surgical Endoscopy
Anne G J F van Zoonen, Maarten Schurink, Arend F Bos, Erik Heineman, Jan B F Hulscher
BACKGROUND: An ostomy seems a safe alternative in neonates with an acute abdomen when immediate restoration of bowel continuity is deemed undesirable. Faced with several complications in our center, and the feeling we are not the only center with these complications, we decided to assess the rate and type of complications after both ostomy creation and closure. METHODS: All data regarding neonates (<30 days of age) who underwent a laparotomy for a suspected abdominal emergency in the period 2000 to 2010 were retrospectively analyzed...
August 2012: European Journal of Pediatric Surgery
Christina Feng, Feroze Sidhwa, Seema Anandalwar, Elliot C Pennington, Sonja Ziniel, Saleem Islam, Shawn D St Peter, Fizan Abdullah, Adam B Goldin, Shawn J Rangel
PURPOSE: Despite rigorous data from adult literature demonstrating that oral antibiotics (OA) reduce infectious complications and mechanical bowel preparation (MBP) alone does not, MBP alone remains the preferred approach among pediatric surgeons. We aimed to explore the nature of this discrepancy through a survey of the American Pediatric Surgical Association membership. METHODS: Surgeons were queried for their choice of bowel preparation, factors influencing their practice, and their impression of the strength and relevance of the adult literature to pediatric practice...
June 2015: Journal of Pediatric Surgery
M W Gauderer, R J Izant
Stomal prolapse is a common complication of colostomies and, if severe, may affect the timing of the definitive procedure. A simple technique for postreduction bowel fixation without stomal revision is presented. The reduced bowel is attached to the parietal peritoneum using a "U" type suture a few centimeters from the stoma. Two short parallel segments of latex tubing prevent the thread from cutting through. Suture and bolsters are removed when adhesions are established. In one of the four children, a percutaneous cecostomy was employed to connect a prolapse of the entire proximal colon...
December 1985: Journal of Pediatric Surgery
Hemonta K Dutta, Neeraj Gandhi
Colostomy prolapse is a major cause of morbidity in paediatric patients with Hirschsprung's disease and anorectal malformations. Although it is commonly associated with the distal loop of a transverse colostomy, a sigmoid stoma can also be affected. We report six babies with anorectal malformations between day 10 and 6 months presenting with incessant crying and irritability following prolapsed colostomy stomas. In four patients only the distal stomas were involved but in the other two both proximal as well as distal loops had prolapsed...
December 2009: Pediatric Surgery International
Hiroki Takahashi, Masayasu Hara, Satoru Takayama, Yoichi Matsuo, Mikinori Sato, Masahiro Kimura, Hiromitsu Takeyama
Prolapse of loop colostomy or ileostomy is a common complication and markedly reduces patient quality of life. Many techniques have been reported for surgical or nonsurgical management of prolapse. We here report a simple laparoscopic technique for loop stoma prolapse. The prolapsed intestine (usually distal limb) was fixed to the abdominal wall by laparoscopic suturing. This technique should represent a good option for management of loop colostomy prolapse and can be applied to loop ileostomy or single stoma prolapse...
October 2012: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
R Shapiro, E H Chin, R M Steinhagen
Prolapse is a well-described complication after ileostomy or colostomy, and is typically asymptomatic and easily reduced. Acute incarceration of a prolapsed stoma is a rare event, however. A patient presented with an incarcerated, prolapsed ileostomy causing small bowel obstruction and stomal ischemia. Successful reduction was performed with the assistance of sugar as a desiccant. Incarceration of a prolapsed ileostomy is highly atypical, but can be approached in a similar manner to an incarcerated rectal prolapse...
September 2010: Techniques in Coloproctology
Andrea C Bafford, Jennifer L Irani
Stomas are created for a wide range of indications such as temporary protection of a high-risk anastomosis, diversion of sepsis, or permanent relief of obstructed defecation or incontinence. Yet this seemingly benign procedure is associated with an overall complication rate of up to 70%. Therefore, surgeons caring for patients with gastrointestinal diseases must be proficient not only with stoma creation but also with managing postoperative stoma-related complications. This article reviews the common complications associated with ostomy creation and strategies for their management...
February 2013: Surgical Clinics of North America
S H Ein
A loop colostomy in infants and children is usually temporary, made through a small abdominal incision, and frequently prolapses its distal limb within months of its construction. Once this prolapse occurs, its permanent reduction is hardly ever achieved. On the other hand, the colostomy that is made at the time of a major laparotomy and the colostomy whose limbs are brought out through separate abdominal wall openings, rarely prolapse. The advantage of the loop colostomy over the latter two types is that it is easier to make and easier to close...
February 1984: American Journal of Surgery
G Steinau, K M Ruhl, H Hörnchen, V Schumpelick
BACKGROUND: A number of severe gastrointestinal disorders in infancy and childhood may require the formation of an enterostomy as a crucial part of the treatment of the disease itself. This study reviews our pediatric patients with regard to the morbidity and mortality of enterostomy formation and closure over an 8-year period. PATIENTS AND METHODS: Sixty-eight enterostomies in infants and children and 60 consecutive enterostomy closures in retrospect are reported on...
August 2001: Langenbeck's Archives of Surgery
A Dokucu, H Oztürk, Y Yağmur, S Otçu, A Onen, O F Azal, F Gürkan, S Yücesan
BACKGROUND/PURPOSE: Colonic injuries are rare in childhood, but when they do occur, they are mostly associated with penetrating abdominal injuries. The primary repair of colon injuries without stoma is still controversial within surgical experience, and the potential risk factors affecting morbidity and mortality is not sufficiently known. METHODS: Between 1985 and 1997, 34 children presenting with traumatic colonic perforations were reevaluated by analyzing the relationship between the overall morbidity and mortality and the potential risk factors...
December 2000: Journal of Pediatric Surgery
Elliott R Haut, Michael L Nance, Martin S Keller, Jonathan I Groner, Henri R Ford, Ann Kuhn, Barbara Tuchfarber, Victor Garcia, C William Schwab, Perry W Stafford
PURPOSE: Management of civilian penetrating colon injuries in the adult has evolved from the universal use of fecal diversion to the highly selective use of colostomy. We hypothesized that a similar management approach was appropriate for the pediatric population. METHODS: A retrospective review of pediatric patients (age <17 years) with a penetrating colorectal injury was performed at six Level I trauma centers for the period January 1990 through June 2001. RESULTS: For the period of review, 53 children with a penetrating colorectal injury were identified...
September 2004: Diseases of the Colon and Rectum
Claudio De Carli, Marcos Bettolli, Carl-Christian Jackson, Brian Sweeney, Steven Rubin
INTRODUCTION: Colostomy morbidity has been reported to be as high as 50%. Laparoscopic-assisted colostomy (LAC) is associated with decreased colostomy complication. LAC is recommended for stoma formation in adults but has not been previously reported in children. In this paper, we report on our initial experience with LAC in children. MATERIALS AND METHODS: Using a two- to four-port (3.5-mm) technique, LAC was performed in a female with an imperforate anus and 2 male patients with complicated Hirschsprung's disease (HD), respectively...
June 2008: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Sabine Irtan, Marc Bellaïche, Christopher Brasher, Alaa El Ghoneimi, Jean Paul Cézard, Arnaud Bonnard
AIM: The aim of the study was to evaluate the morbidity rate of stoma in children diagnosed with chronic intestinal pseudoobstruction (CIPO) and try to determine risk factors. MATERIAL AND METHODS: Twenty-two children (65%) of 34 referred to our center between 1988 and 2008 had a stoma. They were compared with 22 other children referred for another pathology necessitating a stoma. RESULTS: The incidence of stomal prolapse in CIPO children was 45% vs 9% in non-CIPO children (P = ...
November 2010: Journal of Pediatric Surgery
S Rokhsar, E A Harrison, D B Shaul, J D Phillips
BACKGROUND/PURPOSE: When performing an urgent gastrointestinal operation on an immunocompromised child, the pediatric surgeon may have to decide between performing an intestinal anastomosis (and risk leakage or sepsis) or creating an intestinal stoma. This study evaluates the postoperative course of those patients treated with intestinal stomas and the long-term survival rate of such patients. METHODS: A 13-year retrospective review of immunocompromised children with intestinal stomas was performed...
December 1999: Journal of Pediatric Surgery
2015-02-14 17:32:25
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