Intestinal Stoma Prolapse and Surgical Treatments of This Condition in Children: A Systematic Review and a Retrospective Study

Abstract

Background: An intestinal stoma is a surgical opening of the intestine, mostly sutured to the anterior abdominal wall. Stoma prolapse is one of the common complications of stoma. A significant number of stoma prolapse patients require surgical correction. Aim: The first part of this thesis is a literature review of intestinal stoma prolapse and its surgical treatments. The second part is an evaluation of the effect of surgical treatments of this condition on children at OUS-R. Methods: Literature — A literature search was performed. Fifty-seven English-language studies were selected. Methods: Patients evaluation: Design, Setting, and Participants — A retrospective review of pediatric patients (<13 years) surgically treated for intestinal stoma prolapse at OUS-R. Results: Literature — Incidence of intestinal stoma prolapse for children varies from 8.1% to 25.6%. Many proposed surgical repair procedures for stoma prolapse are available and var y from being ineffective to 100% effective. Results: Patients evaluation at OUS-R — From 2001 to 2013, 14 of the 304 children with stoma (4.6%), experienced stoma prolapse. Nine stoma prolapse were surgically corrected: Median age at stoma formation for the 9 patients was 1.7 years. Surgical procedures and success rate: Median 2, range 1 - 9 operations/person; varies from being ineffective to 50% effective. Conclusion: Limited data suggests stoma prolapse repair is a surgical challenge. Thus, preferably when possible, closure of the stoma would be most suitable. Incidence of stoma prolapse in our series of pediatric patients at Oslo University Hospital is lower than most published incidence in the pediatric medical literature.