SINGLE LAYER OR DOUBLE LAYER FOR PEDIATRIC COLOSTOMY CLOSURE: WHICH IS BETTER? A COMPARATIVE STUDY

Background/Purpose: Colostomy formation and colostomy closure (CC) procedures are common operations 
frequently be performed in pediatric patients. Despite its benefits, it can produce significant morbidity and 
mortality. Few reports examined the outcome, complications and factors influencing the outcome of CC in 
pediatric age group. The aim of this study is to compare the outcome of two different technical details; single 
layer interrupted extramucosal closure and double layer interrupted closure; for pediatric CC.
Patients and Methods: In this prospective randomized comparative study all infants and children admitted 
for colostomy closure from January 2008 to December 2011 were included and were allocated prospectively 
into 2 groups according to technique used in CC. Group A consisted of 40 patients in whom CC was done 
with single layer interrupted extramucosal closure. Group B consisted of 40 patients in whom their 
colostomies were closed by double layer; the inner layer full thickness interrupted and the outer interrupted 
sero-muscular. Patients’ details and data for CC for each technique all were collected, recorded and 
compared. Statistical analysis was carried out using SPSS.
Results: The statistical analysis showed that there was statistically very highly significant difference between 
the two groups concerning mean operative time (P=0.00) and significant difference regarding mean time for 
passing first bowel motion postoperatively (P=0.04). Postoperative CC related complications (wound 
infection, anastomotic leak, gastroenteritis and incisional hernia) were reported in12 (15%) patients. There 
was statistically significant difference between both groups regarding the incidence of overall postoperative 
complications.
Conclusion: We advise single layer interrupted extramucosal closure technique as it carries shorter mean 
operative time and less complications rates.