EFFECT OF HYDRODISTENSION OF THE DISTAL LOOP OF COLOSTOMY ON GUT CALIBER AND EARLY POSTOPERATIVE RECOVERY IN PAEDIATRIC PATIENTS WITH ANORECTAL MALFORMATIONS BEFORE STOMA CLOSURE

Abstract

Background:: ARMs are anorectal malformations that need to be managed in a staged way; the formation of colostomy and its eventual closure. Slow postoperative bowel movements and problems after stoma reversal are still important issues that are frequently related to the disuse of the distal bowel and hypotrophy. Bowel-conditioning Preoperative distal loop hydrodistension has been suggested as a technique to enhance postoperative results.

Objective: To compare the outcomes of colostomy closure in pediatric patients with anorectal malformations with and without preoperative distal loop hydrodistension in terms of bowel calibre and early postoperative recovery.

Methods: It was a comparative cross-sectional study carried out at the Department of Pediatric Surgery, National Institute of Child Health, Karachi from 12 March, 2026 to 11 June, 2026. A total of 60 patients aged 1-12 years were used with 30 patients in hydrodistension group and 30 in the control group. Distal loop colostogram results obtained before operation were captured and those measures of bowel calibre as taken during operation. Outcomes such as time to first stool passage, complications and hospital stay were evaluated postoperative. Appropriate tests were used to conduct the statistical analysis and the significance level used was p < 0.05.

Results: Patients in the hydrodistension group demonstrated improved distal bowel calibre and lower incidence of significant calibre discrepancy. The mean time to first stool passage was shorter in the hydrodistension group compared to the control group, and hospital stay was also reduced. Postoperative complications were less frequent in the hydrodistension group; However, the difference was not statistically significant (p > 0.05).

Conclusion: Preoperative distal loop hydrodistension is an inexpensive and easy-to-use procedure that can potentially enhance the recovery of bowel functions and prolongation of hospital stay after colostomy repair in children with anorectal malformations. The findings should be further supported by multicenter randomized studies in order to validate them and determine long-term outcomes.