Complication risks of intestinal stomas in children: a case series

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Abstract

BACKGROUND: An intestinal stoma is one of the necessary therapeutic stages following bowel resection for acute abdominal surgical conditions in children. It facilitates the postoperative course. The next treatment stage is the restoration of intestinal continuity. Both formation and closure of an intestinal stoma may be associated with various complications.

AIM: This work aimed to analyze the causes of intestinal stoma–related complications in children based on data from a regional pediatric hospital providing tertiary specialized medical care.

METHODS: We reviewed the surgical management of 62 children treated in the surgical department of a regional multidisciplinary pediatric hospital and a regional perinatal center between 2015 and 2024. Based on stoma level, patients were classified as follows: jejunostomy — 13 children; ileostomy — 47; colostomy — 2. An end stoma was created in 42 children; a double-barrel stoma according to Mikulicz (J. Mikulicz) in 10; a Santulli–Blanc stoma in 4; and a Bishop–Koop stoma in 6 patients.

RESULTS: After stoma formation, complications occurred in 22 children (35.4%), including: stoma obstruction in 1 child, stoma retraction in 3, stoma necrosis in 1, peristomal skin irritation in 12, stoma stenosis in 2, mucosal prolapse in 2, and stoma-wall fistula in 1. After stoma closure, complications were observed in 18 children (29%): anastomotic leak in 2 cases (3.2%), adhesive small-bowel obstruction in 4 (6.4%), surgical wound infection in 7 (11.3%), and prolonged functional bowel obstruction in 5 children (8%).

CONCLUSION: Formation and closure of an intestinal stoma are associated with a range of complications. Strict adherence to surgical technique during stoma formation is essential for preventing complications and ensuring a favorable postoperative course. To reduce the number of postoperative complications, it is essential to perform stoma closure within the appropriate timeframe and to select the optimal anastomosis technique.

About the authors

Bulat K. Dzhenalaev

Marat Ospanov West Kazakhstan Medical University

Email: Dzhenalaev@mail.ru
ORCID iD: 0000-0001-7494-5072
SPIN-code: 5830-0523

MD, Dr. Sci. (Medicine), Professor

Kazakhstan, Aktobe

Sagidulla P. Dosmagambetov

Marat Ospanov West Kazakhstan Medical University

Author for correspondence.
Email: Dossag2011@mail.ru
ORCID iD: 0000-0002-6525-8438
SPIN-code: 2958-1298

MD, Cand. Sci. (Medicine), Assistant Professor

Kazakhstan, Aktobe

Asylbek B. Tussupkaliev

Marat Ospanov West Kazakhstan Medical University

Email: a.tusupkaliev@mail.ru
ORCID iD: 0000-0003-2386-2984

MD, Cand. Sci. (Medicine), Assistant Professor

Kazakhstan, Aktobe

Nailya S. Esenalina

Marat Ospanov West Kazakhstan Medical University

Email: nailyaesenalina@gmail.com
ORCID iD: 0000-0003-1990-9655
Kazakhstan, Aktobe

Bauyrzhan N. Bissaliyev

Marat Ospanov West Kazakhstan Medical University

Email: baurjan.79@mail.ru
ORCID iD: 0000-0002-4875-1140
SPIN-code: 2720-6602

MD, Cand. Sci. (Medicine), Assistant Professor

Kazakhstan, Aktobe

Zhenisbek T. Baubekov

Marat Ospanov West Kazakhstan Medical University

Email: zh.tanir@mail.ru
ORCID iD: 0000-0001-7274-7478

MD, Cand. Sci. (Medicine)

Kazakhstan, Aktobe

Kairat K. Zhalmukhambetov

Marat Ospanov West Kazakhstan Medical University

Email: kaira_kz@mail.ru
ORCID iD: 0009-0001-3292-3286
Kazakhstan, Aktobe

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