Outcome of Colostomies in Children: A Review of 48 Cases at Nnamdi Azikiwe University Teaching Hospital Nnewi, Nigeria

Background: Colostomies in children are common abdominal procedures in paediatric surgical practice and are often temporarily created for the purpose of diversion of faeces and flatus, hence would need to be closed when the primary pathology is sorted out. Aim: To determine outcome of colostomies performed in children at NnamdiAzikiwe University Teaching Hospital Nnewi (NAUTH)and seek for modifications for improvement. Methodology: This was a retrospective review of 48 children who had colostomies at NAUTH Nnewi over a 6- year period. Data were obtained and entered into an already prepared protocol sheet and analyzed using (IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) Pearson Chi square test was used to test for associations between categorical variables. Statistical significance was inferred at p value of ≤0.05. Results: A total of 48 children who had colostomies were evaluated. The age range was 1 day -10 years, median age was 2 days. There were 38 males (79.2%) and 10 females (20.8%). Anorectal malformations 33(62.5%) and Hirschsprung's disease 11(22.9%) were the most common indications. Both sigmoid and transverse defunctioning colostomies were performed in 23(47.9%) patients each while caecostomy and Hartman's operation were done in one (2.1%) patient each. There were complications in 17(35.4%) patients. Out of this, skin excoriations observed in 46.2% was the most common. Only 24(50%) of the patients went on to have their definitive surgeries. Seven (14.6%) were lost to follow-up while 10 mortalities occurred within the study period. The mean interval between creation of colostomy and definitive surgery was 10.72 months ±7.20 and duration of follow up was 1- 6 years. Conclusion: Only a few of our patients who had colostomy progressed to access definitive treatment of their primary disease conditions. Perhaps carrying out more of single staged procedures where feasible and a review of the choice of colostomy informed by the pathology may help reduce the high morbidity and attrition associated with colostomies in children.