COLOSTOMY IN COMPLICATIONS OF SURGICAL CORRECTION OF ANORECTAL MALFORMATIONS IN CHILDREN ANORECTAL MALFORMATIONS IN CHILDREN

Abstract

Anorectal malformations in children are still one of the complex problems of pediatric coloproctology. The majority of pediatric surgeons continue to adhere to the opinion about the expediency of preliminary colostomy and delayed proctoplasty, motivating this tactics by the possibility of creating optimal conditions for performing a complex intervention, reducing anesthesiological risk, avoiding technical errors. Purpose of the study. To improve the results of treatment of anorectal malformations in children with preliminary colostomy. Material and methods. In our work we analyzed the use of 154 (100%) colostomies. 117 (76%) children with and without fistulous and high fistulous forms of anorectal malformation with already formed preliminary colostomy were treated in pediatric surgery departments of the clinic of Andijan State Medical Institute during the period from 2005 to 2021 in Perinatal Centers or in clinics at the place of residence. The age of the children ranged from 2 months to 14 years.  Results. Colostomy (ileostomy) formation was performed directly by us in 37 (24%) children. Of these, 9 (5.8%) children were treated as the first stage before primary radical correction in case of high malformation and 10 (6.5%) children previously operated on once or several times with the development of gross anatomo-functional disorders of the descended intestine and perineum requiring repeated corrective surgeries, 5 (3.2%) patients underwent colostomies after the development of complications in the early postoperative period, in 13 (8.5%) cases colostomies were formed in case of concomitant anomalies and malformations that clinically "dominated" over anorectal malformation. Conclusions. 1) Repeated corrective surgeries in all cases of complications should be performed only under the cover of "protective" colostomy. 2) Formation of a single-barrel end colostomy (sigmostoma) is preferable; 3) Colostomy is necessary in cases of concomitant anomalies and malformations that are clinically "dominant" over the anorectal malformation;