Wu Caiwei,Yang Shaobo,Zhu Haitao,et al.Investigation on the colostomy style of high anorectal malformation[J].Journal of Clinical Pediatric Surgery,,18():480-483,497.[doi:10.3969/j.issn.1671-6353.2019.06.009]
Investigation on the colostomy style of high anorectal malformation
- Keywords:
- Digestive System Abnormalities; Colostomy/MT
- CLC:
- R726.2;R657.1+1
- Abstract:
- Objective To compare the advantages and disadvantages of loop colostomy and sigmoid colon isolated ostomy for congenital high anorectal malformation. Methods Retrospective analysis was performed for 148 cases of congenital high anorectal malformations from June 2007 to June 2017. There were 115 boys and 33 girls with a mean birth weight of (3 240±572) grams and a mean gestational age of (38.07±1.1) weeks. They were divided into 3 groups according to ostomy style:group A of loop colostomy (A1 in transverse colon,A2 in sigmoid colon),group B of sigmoid colon isolated ostomy with distal intestinal bowel narrowing and group C of sigmoid colon isolated ostomy. The operative duration,postoperative complications,preoperative evaluation of stage Ⅱ surgery of each group were analyzed. Results No differences existed in birth weight,gestational age and operation time of ostomy among 3 groups (P>0.05). Visualization success of distal bowel occurred before stage Ⅱ surgery in group A1 (n=3,20.0%),group A2 (n=4,66.7%),group B (n=46,79.3%) and group C (n=20,62.5%). The difference was statistically significant among 3 groups in visualization success rate of distal bowel (χ2=18.834,P<0.001). Distal ostomy occluded in group B (n=3) and no distal ostomy occlusion in group A/C. Distal intestinal bowel stercoroma and secondary expansion occurred in group A (n=13,group A1; n=3,group A2) and no distal intestinal bowel stercoroma in group B/C. The difference was statistically significant in distal intestinal bowel stercoroma and secondary expansion among 3 groups (χ2=45.276,P<0.05). Incision infection occurred in group A (n=5),group B (n=1) and group C (n=1). And the difference was statistically significant among 3 groups (χ2=6.745,P<0.05). Bowel prolapse occurred in group A (n=1),group B (n=3) and group C (n=2). And no significant difference existed in bowel prolapse among 3 groups (χ2=0.426,P=0.808). Conclusion The effect of sigmoid colon isolated ostomy is better than that of loop colostomy and sigmoid colon isolated ostomy with distal intestinal bowel narrowing. Sigmoid colon ostomy close to descending colon avoids the difficulty of stage Ⅱ operation.
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Memo
收稿日期:2018-02-12。
通讯作者:陈功,Email:chengongzlp@hotmail.com