Indications and Colostomy Level Choice at the Stages of Surgical Correction of Fistulous and Non-fistulous Forms of Anorectal Malformations in Children

O. O. Kurtash

Abstract


Anorectal malformations (ARM) are a complex, often combined type of pathology that requires deliberate differential approach to the problem of timing and methods of radical surgical correction of this type of anomaly. There is no single viewpoint regarding expediency of colostomy at the stage of ARM correction in children. There are different views concerning the type and level of colostomy formation. The terms of staging interventions in patients with colostomy are not determined. It is essential to study the characteristics of colostomy in different types of ARM in girls and boys.

The objective of the research was to improve the results of surgical correction in children with ARM.

Materials and methods of research. Analysis of diagnosis and treatment of 205 children with ARM was conducted including 115 (56.10%) girls and 90 (43.90%) boys.

Results of the research and their discussion. ARM was found to be a complex congenital disorder with fistula in 83.90% of cases and without fistula in 16.10% of cases with the signs of partial or complete intestinal obstruction. The severity of the defect depends on the fistulous variants of connection between rectal lumen and other organs of urogenital system, the diameter of this anastomosis and concomitant anomalies.

Conclusions. Colostomy is a necessary step in the surgical correction of all (except anal membrane) forms of anorectal malformations in children.

The choice of colostomy type depends on verification of disorder involving radiation diagnostic methods. Sigmoid colon in neonates and infants takes up one third of the total length of the colon with significant mobile mesentery. Taking into account its segmental blood supply, colostomy formation in children of this age group in this place is convenient and effective. 


Keywords


Anorectal malformations, diagnostics; treatment; colostomy; results; children

Full Text:

PDF

References


Hassink E.A., Rieu P.N., Hamel B.C. et al. Additional congenital defects in anorectal malformations. 2006; 155, 6: 477–482.

McLorie G.A., Merguerian P.A., DeMaria J.E. et al. Injuries to the genitourinary system during a posterior sagittal approach and their repair. Br. J. Urol. 2008; 81: 76.

Mickelson J., G. Blair The posterior urethra in anorectal malformations. J. Pediatr. Surg. 2007; 42: 585–587.

Pena A. Levitt M. Imperforate anus and cloacal malformations. Pediatric surgery. Philadelphia, PA: Saunders. 2005: 496–517.

Levitt M.A., Bischoff A., Breech L., Pena A. Rectovestibular fistula - rarely recognises associated gynaecologic anomalies. J. Pediat. Surg. 2009; 44: 1261-1267.

Rintala R.J. Congenital anorectal malformations: anything new? J. Pediatr. Gastroenterol. Nutr. 2009; 48, 2: 79-82.

Moore S.W., Alexander A., Sidler D. et al. The spectrum of anorectal malformations in Africa. Pediatr. Surg. Int. 2008; 24: 677-783.




Copyright (c) 2017 O. O. Kurtash

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.


IFNMU Logo

Free counters!