Colostomy ReversalAmong patients with Anorectal Malformations, Colostomy Reversal is done after PSARP and confirming that child has successfully completed the Anal Dilatation Program. If Colostomy had been made due to any other reason, like Hirschsprung’s disease or some other reason, then Colostomy reversal is done once the primary pathology/problem has settled down, and the child is ready for this procedure.
Before Colostomy Reversal:Before this surgery, our team will examine the child , and they will check the general health. They will advise some investigations of blood. Sometimes, if needed, they may advise a repeat Ultrasound, and Distal Loopogram (a Radiology investigation). Most of the time, children require Gut preparation before this surgery. The basic aim of Gut preparation is to empty the gut of the child. So that when we join both ends together, there will be minimal pressure over this anastomosis in the initial days. For this matter, different surgeons follow different regimens. At our center, we follow three days regimens, as it starts 3 days before surgery.
Surgical Procedure:In this surgery, surgeon will make an incision around the colostomy site. Then he will mobilize these stomas. Then he will suture both ends with each other. Usually, this surgery takes about 2 to 3 hours.
After Colostomy Reversal:
- After surgery, usually, we allow the feeding to child after 3 to 4 days. During these days, we do not allow the child to take anything from the mouth. During this period, we start Intravenous fluids and antibiotics and continue it for 5 days.
- The child will need to stay in the hospital for 4 to 6 days as per his recovery.
- After this surgery, Anal Dilatation Program is continued for a few more months.
- We will keep the child will in regular follow up. We advise to start toilet training at the age of 3 years. Most of the children with Anorectal Malformations require Bowel Management Program at 3 years of age.
Some FAQ's About Colostomy Reversal
The success rates for colostomy reversals is usually 95%-98%. If your doctors has decided to close the stoma, then there will be a good reason behind that and it should have high success rate.
Reversing a loop colostomy is relatively easy for surgeons to do. They make an incision around the stoma which gives them access to your abdominal cavity and then reattaches the upper section of your colon back onto the remains.
Usually it takes upto 2 hours.
The usual hospital stay after colosotomy revearsal surgery is 3-5 days.
The end colostomy is also reversable but much more complicated. Larger incisions have to be made and it takes a longer time to recover from this type of surgery. There is also a greater risk of complications during the healing process.
Once your appetite has returned and you’re feeling a bit better, it is time to reintroduce some foods into your diet. You can start by including foods from each of the following groups: • Protein-rich food such as fish, meat, eggs, beans, nuts, lentils
• Dairy that contains calcium and protein like milk cheese yoghurt
• Starchy food such as rice, bread, pasta, potatoes
• Fruit & vegetables
• Fat – if you are underweight fat can be an important source of energy. If overweight limit fats but make sure that you stay well supplied with Omega-3 essential fatty acids
Ostomy surgery is a type of surgery that happens when needed and at any age. There are many reasons for such an operation: birth defects, cancer, inflammatory bowel disease, diverticulitis or incontinence to name a few. This type of treatment does not lower your life expectancy.
Follow the directions your surgeon gives you in order to prepare for surgery. For a few days before, you may be told not to eat any solid foods and only drink clear liquids such as water, broth, apple juice or lemon-lime soft drinks. You can also eat gelatin or suck on ice chips, if instructed by your doctor.
Yes, you can eat anything.