유소아 장루의 합병증
Stomal Complications in Infants and Children
전시열, 최현철, 이석, 정극원, 정우식,
소속 상세정보
전시열 ( Jun Si-Youl )
성균관대학교 의과대학 마산삼성병원 외과학교실
최현철 ( Choi Hyun-Chul )
성균관대학교 의과대학 마산삼성병원 외과학교실
이석 ( Lee Seok )
성균관대학교 의과대학 마산삼성병원 외과학교실
정극원 ( Jung Keuk-Won )
성균관대학교 의과대학 마산삼성병원 외과학교실
정우식 ( Jung Woo-Sik )
성균관대학교 의과대학 마산삼성병원 외과학교실
KMID : 0356719980140020299
Abstract
We performed this study to analyse the morbidity and mortality of stoma formation in infants and children over a 17-year period. Thirty-seven stoma formations were performed in 37 patients: 21 for anorectal malformation, 9 for Hirschsprung’s disease, 3 for necrotizing enterocolitis, 2 for multiple ileal atresia, 1 for volvulus neonatorum with perforation, and 1 for diaphragmatic hernia with colon perforation. There were 26 boys and 11 girls with a mean age of 0.4 years. Complications after stoma formation were encountered in 12 patients(32.4%) and included stomal prolapse, stenosis, retraction, dysfunction, skin excoriation and parastomal hernia. Four patients(10.8%) required stomal revision. The incidence of complications was neither related to the age nor to the primary indication for the stoma formation, but sigmoid colostomy was associated with a lower complication rate compared to transverse colostomy(22.1% versus 42.1%, P＜0.05). Five patients died, but only one(2.7%) was dead, which was directly related to stoma formation. Eighteen of these children subsequently underwent stoma closure which was associated with complications in six patients(33.3%). The most common complication after stoma closure was wound sepsis in 4 children. In conclusion, because the significant morbidity of stoma formation still exists the refinements in surgical technique may help in reducing the incidence of complications and a sigmoid loop colostomy should be used whenever possible.
키워드
Colostomy;Complication;Child
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