Burhan BEGER, Metin SİMSEK, Ebuzer DÜZ, Baran Serdar KIZILYILDIZ

Çocuklukta Kolostomi Komplikasyonları: 84 Hastanın Analizi

Giriş: Kolostomiler; konjenital ve edinsel gastrointestinal sistem patolojilerinde hayati bir rol oynamaktadır. Cerrahi yaklaşımlardaki gelişmelere rağmen, cerrahi morbidite ve komplikasyon oranları hala yüksektir. Kolostomi açılma sonrası komplikasyon insidansı literatürde% 10 ile% 74 arasında bildirilmiştir. Gereç ve Yöntem: Van Yuzuncuuyil Üniversitesi ve Van Bölge Eğitim ve Araştırma Hastanesi Çocuk Cerrahisi Kliniği'nde doğumsal ve edinsel patolojilere bağlı kolostomi açılan 84 hasta retrospektif olarak incelendi. Hastalar risk faktörleri, aciliyet durumu, kolostomi açılma nedenleri, karın duvarındaki açılma bölgesinin yeri, tipleri ve komplikasyonları açısından karşılaştırıldı. Bulgular: 84 olguya farklı nedenlerle kolostomi açıldığı saptandı. Hastaların 52'si erkek, 42'si kadındı. En sık anorektal malformasyonlar ve Hirschsprung hastalığı nedeniyle kolostomi açıldı. Olguların% 72'sinde kolostomi ile ilgili komplikasyonlar saptandı. Toplam 14 hastaya kolostomi revizyonu yapıldı. En sık görülen komplikasyon% 67 ile stomal dermatit ve% 16 ile kolostomi prolapsusudur. Sonuç: Cerrahi teknik hataları ve bakımsızlık, hastanın konforunu etkileyerek morbiditeyi arttırmaktadır. Profilaktik bakım ve komplikasyonların bilinmesi morbidite ve mortaliteyi azaltacaktır.

Anahtar Kelimeler:

kolostomi, pediatri, komplikasyon

Colostomy Complications in Childhood: Analysis of 84 Patients

Introduction: Colostomies play a vital role in the surgery of congenital and acquired gastrointestinal system pathologies. Despite improvements in surgical approaches, surgical morbidity and complication rates are still high. The incidence of complications after colostomy is reported in the literature between 10% to 74%.Materials and Methods: Eighty-four patients who underwent colostomy due to congenital and acquired pathologies in pediatric surgery clinics of Van Yuzuncuuyil University and Van Regional Education and Research Hospital were evaluated retrospectively. Patients were compared in terms of risk factors, urgency status, reasons for opening colostomy, location of opening area in abdomen wall, types and complications.Results: 84 patients were found to have colostomy for different reasons. 52 of the patients were male and 42 were female. The most frequent anorectal malformations and Hirschsprung's disease revealed colostomy. Complications related to colostomy were found in 72% of the cases. A total of 14 patients underwent colostomy revision. The most common complication was stomal dermatitis with 67% and colostomy prolapse with 16%. Conclusion: Surgical technique errors and lack of care increase the morbidity by affecting the comfort of the patient. Prophylactic care and awareness of complications will reduce morbidity and mortality.

Keywords:

colostomy, pediatrics, complication,

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1-Soomro BA, Solangi RA, Siddiqui MA. Colostomy in Children: Indications and Complications. Pakistan Journal of Medical Sciences. 2010; 26(4).
2-Çiğdem MK, Onen A, Duran H, Öztürk H, Otçu S. The mechanical complications of colostomy in infants and children: analysis of 473 cases of a single center. Pediatric surgery international.2006; 22(8): 671-676.
3-- Bakal U, Sarac M, Tartar T, Kazez A. Colostomy İn Children. Firat Med. 2015: 20(1); 47-50.
4- Chirdan LB, Uba FA, Ameh EA, Mshelbwala PM. Colostomy for high anorectal malformation: an evaluation of morbidity and mortality in a developing country. Pediatric surgery international.2008; 24(4): 407-410.
5-Demirogullari B, Yilmaz Y, Yildiz GE, Ozen, IO, Karabulut R, Turkyilmaz Z, Kale N. Ostomy complicatıons in patients with anorectal malformations. Pediatric surgery international.2011; 27(10): 1075.
6- Abdur-Rahman L O, Shawyer A, Vizcarra R, Bailey K, Cameron BH. Do geography and resources influence the need for colostomy in Hirschsprung's disease and anorectal malformations? A Canadian association of paediatric surgeons: Association of paediatric surgeons of Nigeria survey. African Journal of Paediatric Surgery.2014; 11(2): 150.
7- Chandramouli B, Srinivasan K, Jagdish S, Ananthakrishnan N. Morbidity and mortality of colostomy and its closure in children. Journal of pediatric surgery.2004; 39(4): 596-599.
8- Londono-Schimmer EE, Leong APK, Phillips RKS. Life table analysis of stomal complications following colostomy. Diseases of the colon & rectum.1994; 37(9): 916-920.
9- Özaydın İ, Taşkın AK, İskender A. Stoma ile ilgili komplikasyonların retrospektif analizi. Journal of Clinical and Experimental Investigations.2013; 4(1).
10- Pena A, Migotto-Krieger M, Levitt MA. Colostomy in anorectal malformations: a procedure with serious but preventable complications. Journal of pediatric surgery.2006; 41(4): 748-756.
11- Wilkins S, Peña A. The role of colostomy in the management of anorectal malformations. Pediatric surgery international. 1998; 3(2-3): 105-109.
12- Chandramouli B, Srinivasan K, Jagdish S, Ananthakrishnan N. Morbidity and mortality of colostomy and its closure in children. Journal of pediatric surgery.2004, 39(4): 596-599.
13- Ekenze SO, Agugua-Obianyo NEN, Amah CC. Colostomy for large bowel anomalies in children: a case controlled study. International Journal of Surgery.2007; 5(4): 273-277.