Pouch Colon Excision + Stoma

Pouch colon excision surgery India

Pouch colon excision is a operation to remove the diseased pouch colon and re-establish bowel continuity, typically by joining the remaining normal colon to the anus. This operation is generally included in definitive repair for infants with anorectal malformations.

Indications

• Congenital pouch colon (CPC) at birth or early infancy.

Symptoms are:

• Abdominal distension
• Inability to pass meconium
• Fecaluria (if fistula to urinary tract)

Surgical Procedure Overview

The specific technique varies by type and length of pouch colon, but usual steps are:

Step 1: Preoperative Preparation

• Stabilize the child (maintenance of fluid balance, electrolytes, infection control).
• Imaging: X-ray, ultrasound, contrast studies to evaluate colon anatomy.
• Occasionally a temporary colostomy is created initially to decompress.

Step 2: Abdominal Surgery

• Open or laparoscopic abdominal technique.
• Localization of the pouch colon.
• Removal of the abnormal pouch and fistula that communicates with the urinary tract.
• Preservation of as much as normal colon as possible.

Step 3: Pull-Through or Anastomosis

• Remaining normal colon or ileum is taken down and anastomosed to the anal canal.
• If there is inadequate colon, ileoanal pull-through can be carried out.

Step 4: Closure

• Proper blood supply and tension-free anastomosis.
• Close incision of abdomen.
• If staged operation, temporary stoma may be left behind.

Postoperative Care

• Infection, bleeding, or bowel obstruction monitoring.
• Gradual feeding.
• Stool softeners as and when required.
• Long-term follow-up for continence and growth.

Factors Affecting Pouch colon stoma procedure cost India

The price of pouch colon stoma surgery in India can be quite different considering various variables. Let's have a look at the detailed breakdown of variables that affect the overall cost:

Hospital Type and Location

• Private Hospitals: Generally more costly as they have better facilities and individual attention.
• Government Hospitals: Provide cheaper rates but with longer waiting lists.
• City Variations: Delhi, Mumbai, Chennai, and Bangalore will have greater expenses owing to improved infrastructure and greater demand.

Surgeon's Expertise

• Advanced and highly skilled surgeons or specialist skill surgeons might have higher charges.

Procedure Complexity

• Complicated surgeries, whether for a primary procedure or as part of a staged treatment plan, may add to the cost.

Preoperative and Postoperative Care

• Diagnostic testing costs, medication expenses, and follow-up visits are added to the total charge.

Hospital Stay Duration

• Extended hospital stay to recover may add to expense.

Congenital pouch colon excision treatment India

Congenital Pouch Colon (CPC) is a rare anorectal malformation that is characterized by the presence of a dilated, shortened colon, usually with communication between the colon and the genitourinary tract. It is more common in South Asia, especially in India. Treatment is usually surgical, although it may vary depending on the severity and nature of the problem.

Surgical Management in India:

Initial Stabilization

• Neonatal Care: Stabilization of the newborn is attended to promptly, problems such as sepsis, electrolyte disturbances, and respiratory distress being addressed.
• Diagnostic Imaging: A cross-table lateral view (invertogram) is often employed to evaluate the anatomy and to confirm the diagnosis of CPC.

Surgical Approaches

• Single-Stage Procedure: It encompasses pouch excision, fistula ligation if any, and an abdominoperineal pull-through or posterior sagittal anorectoplasty (PSARP). It has been found to have good continence and cosmetic outcomes

Staged Procedures: In more severe cases, a staged procedure can be followed:

• Stage 1: Creation of a colostomy or ileostomy to divert fecal flow.
• Stage 2: Pouch excision and coloplasty.
• Stage 3: Pull-through operation to restore anal continuity.

This planned approach is generally used for CPC types I and II

Postoperative Care

• Monitoring: Postoperative intensive care is delivered to observe for anastomotic leaks, infection, or electrolyte imbalance complications.
• Rehabilitation: Constitutes nutritional supplementation, bowel training, and routine follow-up visits to check for growth and development.

Best hospitals for pouch colon surgery India

• Artemis Hospital, Gurgaon
• Medanta-The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket

Pediatric pouch colon stoma surgery India

Here is a comprehensive description of pediatric pouch colon stoma surgery, which is performed frequently in children with congenital pouch colon (CPC)—a congenital anorectal malformation:

What is Pediatric Pouch Colon Stoma Surgery?

• A pouch colon stoma surgery creates an artificial opening (stoma) on the abdomen to divert stool.
• It is often the initial stage of treatment in infant or newborn with CPC to decompress, avoid infection, and stabilize the child prior to ultimate repair.
• The stoma may be a colostomy (from colon) or an ileostomy (from small intestine) based on the amount of normal colon available.

Indications

• Newborns with obstructing pouch colon.
• Sepsis or poor overall condition necessitating preliminary diversion.
• High-risk anatomy rendering immediate definitive repair hazardous. 

Surgical Procedure Overview

Step 1: Preoperative Preparation

• Equalize fluid and electrolytes.
• Treat infection.
• Imaging: Contrast study or X-ray to delineate anatomy.

Step 2: Construction of the Stoma

• Abdominal incision.
• Colon or ileum normal segment is located.
• Stoma construction: the bowel is exteriorized and sewn to the skin.

Types of stoma:

• End stoma: One end of intestine only is exteriorized.
• Loop stoma: Exteriorization of a loop of intestine with two orifices (proximal and distal).

Step 3: Closure

• Skin closure over the stoma.
• Instructions on stoma care to parents.

Postoperative Care

• Observation for stoma complications (bleeding, infection, retraction).
• Adequate stoma care and appliance fitting.
• Resumption of gradual feeding and bowel control.
• Preparation for definitive pouch colon excision and pull-through procedure once the child stabilizes.

Conclusion

Pediatric pouch colon stoma surgery is an important initial treatment for congenital pouch colon (CPC) in infants and neonates. By establishing a temporary stoma, the surgery unblocks the bowel, prevents infection, and stabilizes the infant, preparing them for complete repair. The operation is usually safe and efficacious, particularly when conducted at specialized pediatric surgical facilities. With appropriate and timely intervention, CPC children can have satisfactory growth, bowel function, and quality of life.

Pouch colon excision surgery in India with GetWellGo

GetWellGo is regarded as a leading supplier of healthcare services. We help our foreign clients choose the best treatment locations that suit their needs both financially and medically.

We offer:

• Complete transparency
• Fair costs.
• 24 hour availability.
• Medical E-visas
• Online consultation from recognized Indian experts.
• Assistance in selecting India's top hospitals for Pouch colon excision surgery.
• Expert colorectal surgeon with a strong track record of success
• Assistance during and after the course of treatment.
• Language Support
• Travel and Accommodation Services
• Case manager assigned to every patient to provide seamless support in and out of the hospital like appointment booking
• Local SIM Cards
• Currency Exchange
• Arranging Patient’s local food

FAQ

At what age is stoma surgery typically performed?

• Generally within the first few days to a few weeks of life, depending on the condition of the newborn.
• Timing is determined according to severity of obstruction, general health, and risk factors.

What kinds of stoma are done?

• Colostomy: From the colon
• Ileostomy: From the small intestine (if colon is not adequate enough)
• May be end stoma or loop stoma, depending on anatomy

Is stoma surgery the absolute treatment?

• No. Stoma surgery would typically be the first step. Definitive management includes:
• Removal of the abnormal colon pouch
• Pull-through of normal ileum or colon to the anus
• Closing of the stoma following definitive repair