47 a Corresponding Adress: BAKAL Unal, Firat University Faculty of Medicine, Department of Pediatric Surgery, Elazig, Turkey Phone: +90 424 2333555 e-mail: ubakal@firat.edu.tr Received/Geliş Tarihi:24.09.2014 Accepted/Kabul Tarihi: 20.10.2014 * This study was presented orally in 30th National Congress of Pediatric Surgery, Ankara. Fırat Tıp Derg/Firat Med J 2015; 20(1): 47-50 Clinical Research Colostomy in Children Unal BAKAL a , Mehmet SARAC, Tugay TARTAR, Ahmet KAZEZ Firat University Faculty of Medicine, Department of Pediatric Surgery, Elazig, Turkey ABSTRACT Objective: In this study; the rate of complications and mortality of colostomy procedure were investigated in children. Material and Method: Ninety six patients who have undergone colostomy procedure in our clinic between 1996 and 2012 due to different reasons were analyzed retrospectively. Results: Fifty-seven of the patients were male and 39 were female. Their ages ranged from 1 day to 13 (mean 1,1 years) years, and 52 of them were younger than 1 month of age. The most frequent indications for colostomy was anorectal malformations in 57 patients and Hirschsprung's disease in 26 patients. The type of colostomy was separated or modified separated in 53, loop in 27, and Hartmann in 16 patients. There were 36 postoperative complications in 34 cases. Peristomal dermatitis have been detected in 19 (53 %), stomal bleeding in 4 (11%), prolapse in 4 (11%), stomal ischemia in 4 (11%), evisceration in 3 (8%) and stomal stenosis or obstruction in 2 (5.5%) patients. The complications occurred more frequent in the transverse colon and by Hartmann type colostomies. There was a need for a revision by 7 patients. Death occurred by 10 patients but no one was related with colostomy. All deaths were in the neonatal period, and the most frequent cause was associated major congenital abnormality. Conclusion: The primary pathology is the most important factor in the development of the colostomy complications. Although colostomies' have a high complication rate, the number of patients who need revision is low. Key Words: Colostomy, Complications, Hirschsprung's disease, Anorectal malformations. ÖZET Çocuklarda Kolostomi Amaç: Bu çalışmada kolostomili çocuklarda mortalite, morbidite ve risk faktörleri araştırıldı. Gereç ve Yöntem: Kliniğimizde 1996-2012 yılları arasında kolostomi yapılan 96 hasta geriye dönük olarak analiz edildi. Bulgular: Hastaların 57’si (% 60) erkek, 39’u (%40) kız idi Yaşları bir gün ile 13 yaş arasında değişen olguların 52’si (%54) bir aydan küçük, 24’ü (%25) bir ay-bir yaş aralığında, 20’si (%19) ise bir yaşından büyüktü. . Kolostomi endikasyonu en sık anorektal malformasyonlar 51(%53) ve Hirschsprung 23 (%24) hastalıklarıydı. Kolostomi tipleri 53’ünde (%55) separe ve modifiye separe, 27’sinde (%28) olup, 16’sında (%16) ise Hartman şeklindeydi. Kolostominin yeri 61 (%63) olguda sigmoid, 29 (%30) olguda transvers kolon, 6 (%6) olguda çekumda idi. Postop 34 (%35) olguda 36 komplikasyon görüldü. Peristomal dermatit 19 (%53), stomal kanama 4 (%11), prolapsus 4 (%11), stomal beslenme bozukluğu 4 (%11), evisserasyon 3 (%8) ve stomal stenoz veya obstrüksiyon 2 (%5.5) hastada görüldü. Komplikasyonlar en sık transvers kolonda ve Hartman tipi kolostomilerde görüldü. Revizyon 7 (%7) hastaya gerekli oldu. Olguların 10’u exitus oldu, hiç birinde primer neden kolostomi değildi. Ölümlerin hepsi yenidoğan yaş döneminde idi ve en sık nedeni majör konjenital anomalilerdi. Sonuç: Kolostomi endikasyonunu gerektiren temel patoloji komplikasyonlarının gelişmesinde en önemli faktördür. Kolostomilerin komplikasyon oranı yüksek olmasına rağmen revizyon gerektiren hasta sayısı düşüktür. Anahtar Kelimeler: Kolostomi, Komplikasyon, Hirschsprungs hastalığı, Anorektal malformasyon. Colostomy is still an important step in the treatment process of congenital abnormalities of the gastrointestinal tract in the newborn and infants as well as in acquired disorders (1, 2). The rate of colostomy complications occuring during the treatment of anorectal malformations (ARM), Hirschsprung's disease (HD) and trauma cases may be high despite the surgical advances (3-5). In this study, the complications and mortality were investigated in patients who had colostomies due to congenital or acquired disorders. MATERIAL AND METHOD The approval was obtained from Firat University Ethics Committee. Ninety six patients who underwent colostomy procedure due to ARM, HD, trauma and miscellaneous diagnoses (ICD codes Q42.3, Q43.1, T79.8, K56.2, P77, K63.1) between 1996 and 2012 were analyzed retrospectively. The patients were analyzed for their ages, gender, colostomy indications, colostomy types, complications and mortality. The data were analyzed using SPSS program and Chi square test.