Diverting loop colostomy in children with skin and muscle bridge - Our technique

Aim: to identify the results of diverting loop colostomy with skin and muscle bridge technique in pediatric surgical patients. setting: department of pediatric surgery,sheikh zayed medical college,rahim yar khan duration with dates: ten (10) months (march -2014 to december -2014) sample size: a total of 60 neonates,infants and children underwent creation of loop colostomy during this period for various congenital and acquired disorders of colon,rectum and anus. study design: quantitative method study type: analytical study methods: all patients admitted in the pediatric surgery department who required diverting colostomy creations as a part of their management were included in the study. these patients were randomly admitted through opd and emergency for diverting loop colostomy with skin and muscle bridge technique where indicated. apart from ascending and transverse colostomies,sigmoid loop colostomy with skin and muscle bridge was the commonly performed procedure in our department. the patients who were operated upon previously or operated elsewhere and referred due to stoma complication were excluded from the study. results: out of sixty patients,37(61.67%) were male and 23(38.37%) were females. 33(55%) cases were neonates and 11(33.34%) were infants. common indications for colostomy were,imperforate anus high variety 34(56.67%),hirschsprung's disease 19(31.67%),rectovaginal fistula 4(6.67%),cloacal exestrophy 2(3.34%) and ascending colon perforation 1(1.67%). sigmoid loop colostomy with skin and muscle bridge was the preferred procedure for anorectal malformation and hirschsprung's disease. parastomal excoriation was the commonest complication and colostomy prolapse was observed in only two patients. conclusion: based on the results of this study we recommend that diverting loop colostomy using a skin and muscle bridge is a safe,rapid and easy to manage colostomy technique which gives complete diversion similar to double barrel colostomy. apart from that morbidity after loop colostomy with skin and muscle bridge is quite less for example colostomy prolapse in loop colostomy without bridge and difficulty in application of colostomy bags due to glass or plastic rod was overcome with skin and muscle bridge technique. so considering the benefits of this technique,skin and muscle bridge method can be confidently used for congenital and acquired conditions in pediatric age groups.