Stoma Reversal Procedure

To compare outcomes of purse-string skin closure and conventional linear skin closure techniques in patients undergoing stoma reversal

This randomized controlled trial compares purse-string versus conventional linear skin closure techniques in children undergoing stoma reversal surgery. The primary aim is to assess surgical site infection rates within 30 days and scar cosmesis at 3 months using the Manchester Scar Scale. Fifty patients (25 per group) will be randomized at Assiut University Pediatric Surgery Department to determine if purse-string closure reduces infections and improves scarring.

The goal of this clinical trial is to learn whether using an Enhanced Recovery After Surgery (ERAS) protocol helps children recover faster after colostomy reversal compared with traditional care. The main question it aims to answer is: Does ERAS lower the number of days children need to stay in the hospital after colostomy reversal compared with traditional care? Researchers will compare two groups: ERAS group - Children receive shorter pre-surgery fasting, no mechanical bowel preparation, early pain control, and early feeding after surgery. Traditional care group - Children receive the usual long bowel preparation, overnight fasting, opioid pain medicine, and a longer period without food after surgery. Participants will: Be randomly assigned to either the ERAS or traditional care group Have their colostomy surgically closed by experienced pediatric surgeons Be monitored daily until they can eat a solid meal without vomiting; this marks the end of their hospital stay The study will enroll 60 children ages 2-13 at Children's Hospital Faisalabad, Pakistan. Researchers will measure length of hospital stay from surgery until discharge as the main outcome.

The goal of this feasibility study is to investigate whether a virtual Hospital at Home is safe and possible for patients undergoing planned minimally invasive colorectal surgery. The study aims to answer the following main questions: What are the patient- and next-of-kin-related effects, as well as the clinical and organizational effects, of home-based admission? What are the implementation barriers for a full-scale randomized controlled trial? Participants will follow a standardized protocol for their care befor, during and after surgery. However, the care after surgery will be conducted at home using telemedicine.