Clinic Reseaech On The Transverse-loop Colostomy Applied In The Phased Treatment Of Congenitalanorectal Malformation

Objective: To explore the advantages and disadvantages of transverse-loop colostomy in the phased treatment of congenital anorectal malformation(ARM),and provide a feasible and effective colostomy selection for the treatment of the ARM.Methods: 62 cases with congenital anorectal malformations were analyzed retrospectively,who were treated with protective transverse-loop colostomy,and the clinical manifestations and results of related important auxiliary examination were analyzed and summarized in order to evaluated the effects and value of the colostomy to ARM children.Results: 1)Before anorectoplasty and colostomy closure,the Peripheral blood routine examination showed that 21 cases(33.9%)and 22cases(35.5%)of mild anemia occurred in 62 cases,respectively,and the mean hemoglobin content of the two groups was(99.17 ± 4.15)g / L and(97.35 ± 4.71)g / L.No severe anemia case occurred.2)The serum albumin examination showed that mild hypoproteinemia occurred in 5patients(8.1%)before anorectoplasty,and the mean plasma albumin was(32.12 ± 0.93)g / L.Before colostomy closure,Only 1 case(1.6%)wasmild hypoproteinemia(plasma protein value 32.7g / L).3)Electrolyte examination showed there were 7 cases(11.3%)with the mild electrolyte disorder before anorectoplasty,and 6 of them had complete recovery before the colostomy closure.There were no hyperchloremic acidosis occurred.4)Urine routine results showed that the number of white blood cells in the urine of 19 children(30.7%)were abnormal before anorectoplasty,and the average number of wbc was(124.42 ± 106.33)/ u L,and only 1 case of ARM with bladder neck fistula occurred the significant symptoms of urinary tract infection.There were 4 cases(6.4%)of abnormal wbc in the urine after the fistula repaired,and the average number of them was(74.75± 52.89)/ uL.5)The high-pressure distal colostogrm with the hydrosoluble contrast media were executed in 57 cases,and the location of the distal rectum and abnormal fistula were detected precisely,and the results were confirmed by the anorectoplasty(100%).The distance from the distal rectum to anal crypt measured by high-pressure distalcolostogrm and operation were(34.63±6.01)mm and(37.33±6.17)mm respectively,and there is no significant difference(t = 0.066,p> 0.05).6)The stoma follow-up results of 62 cases showed no severe cases of bowel retraction,stricture and prolapse.Conclusion:The transverse-loop colostomy can be used in the phased treatment of children with congenital anorectal malformations.The operation is simple and has few complications.It has no serious adverseeffects on nutritional status and growth and development of children.It is a feasible and valusble colostomy method.