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ArticlePediatric surgery international2024

Classic divided sigmoidostomy vs loop sigmoidostomy in anorectal malformations: time for change?

Carla Ramirez-Amoros, Catarina Carvalho, María San Basilio, Leopoldo Martinez, Jose Luis Encinas, Alejandra Vilanova-Sanchez

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Pediatric surgery international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Carla Ramirez-AmorosDepartment of Paediatric Surgery, La Paz Children's University Hospital, Paseo de la Castellana, 261, 28046, Madrid, Spain. carlaramirezamoros@gmail.com.ORCID http://orcid.org/0000-0003-0908-3351
Catarina CarvalhoCentro Materni Infantil Do Norte, Porto, Portugal.
María San BasilioDepartment of Paediatric Surgery, La Paz Children's University Hospital, Paseo de la Castellana, 261, 28046, Madrid, Spain.
Leopoldo MartinezDepartment of Paediatric Surgery, La Paz Children's University Hospital, Paseo de la Castellana, 261, 28046, Madrid, Spain.
Jose Luis EncinasDepartment of Paediatric Surgery, La Paz Children's University Hospital, Paseo de la Castellana, 261, 28046, Madrid, Spain.
Alejandra Vilanova-SanchezDepartment of Paediatric Surgery, La Paz Children's University Hospital, Paseo de la Castellana, 261, 28046, Madrid, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDivided sigmoidostomy (DS) is the classic stoma for patients with anorectal malformations (ARM). Loop sigmoidostomies (LS) in ARM are associated with a higher risk of stoma prolapse and urinary tract infections (UTI). This is not clearly supported by literature. We compared our experience with both techniques.

methodsRetrospective study of ARM patients who underwent DS or LS between 2013 and 2023. We analysed demographics, associated malformations, intraoperative variables, oral intake and stoma functioning times, hospital stay, complications, prolapses, and UTI.

resultsOf 40 patients, 29 underwent open DS and 11 laparoscopic LS. Demographics, malformation type, associated anomalies, surgical time, intraoperative and anaesthetic complications were comparable. Postoperative complications were higher in DS than LS [14(48.3%) vs 1(9.1%), (p = 0.02)], mostly due to wound complications [12(41.3%) vs 0(0%), (p = 0.01)]; with 3 dehiscenses and 3 strictures reintervened. The hours to oral intake and stoma functioning were higher for DS [48(39-90) and 48(24-48) vs 24(24-48) and 24(24-24), (p < 0.05)], with more days of hospital stay [36(19-60) vs 8(5-10), (p = 0.001)]. Prolapses [1(3.4%) vs 1(9.1%)] and UTIs [3(10.3%) vs 1(9.1%) (p > 0.05)] were comparable.

conclusionLS in ARM patients have no higher risk of prolapse or UTI than DS. DS had more complications, mostly wound infections, strictures and dehiscenses.

Indexed as

Anorectal MalformationsSurgical StomasColon, SigmoidColostomyFemaleHumansInfant, NewbornMalePostoperative ComplicationsRetrospective StudiesSigmoidoscopySurgical Wound InfectionTreatment OutcomeUrinary Tract InfectionsAnorectal malformationslaparoscopic loop sigmoidostomyopen divided sigmoidostomy

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.