Evaluation of Factors Affecting Colostomy Closure Outcome in Children: A One-Year Prospective Cohort Study

Abstract

Background: Colostomy Closure is a routine procedure in pediatric surgery services. It is usually done for indications such as anorectal malformation, Hirschsprung's disease, and trauma. It is associated with significant complications. Purpose: To assess the effect of perioperative factors on colostomy closure outcome in children. Methods: This is a prospective observational study on all children who underwent colostomy closure at Tikur Anbessa Specialized Hospital and Menelik II Referral Hospital from January 2019-February 2020, and Demographic data, nutritional status of the child, duration of mechanical bowel preparation, prophylactic antibiotic, type of anastomosis, operative details, and other perioperative factors were recorded, and patients were followed postoperatively for any complications. Data were entered and analyzed using SPSS 23, and perioperative factors were analyzed using chi(2) tests for association with outcome. A p value of <0.05 was considered statistically significant. Results: A total of 71 patients were included in the study, and forty-two (59\%) were female, and the median age was 2.3 years. A total of 23 complications occurred in 13 (18.3\%) patients, and surgical site infection (SSI) was the most common complication occurring in 8 (11.3\%) patients. Four (5.6\%) patients had anemia which required transfusion, and complete wound dehiscence and adhesive intestinal obstruction each occurred in 1 (1.4\%) patient. Duration of surgery >120 min was associated with an increased risk for postoperative need for transfusion; otherwise, there was no association between other perioperative factors and other complications. Conclusion: In this study, except for the duration of surgery, none of the other perioperative factors are associated with the complications of colostomy closure, so a guideline for optimal and uniform perioperative care of children undergoing colostomy closure should be prepared.