ABSTRACT

The creation of an intestinal stoma is an operation frequently performed in pediatric surgery, especially for cases of anorectal malformations and necrotizing enterocolitis, and frequently indicated for Hirschsprung disease. Its purpose is to divert the fecal stream for different reasons. An important step during the creation of a colostomy consists in irrigating, with saline solution, the distal portion of the bowel until it is completely clean of meconium. Leaving meconium distally can result in infection and contamination of the urinary tract. Stoma mislocation may occur in different ways: proximal and distal stomas placed too close to each other, and colostomy created too distal in the sigmoid, not allowing enough distal length for the rectal pull-through. Colostomy closure in the pediatric population is also associated with a high morbidity rate due to potential avoidable complications such as anastomotic dehiscence, stricture, wound infection, bleeding, and death.