Pediatric Colon Surgery

Children's colon and rectal conditions need surgeons who plan for the decades ahead. Pediatric colon surgery aims for a child who is clean, continent and free of a stoma.

Pediatric colon surgery covers operations on the large bowel, rectum and anus in babies, children and teenagers, from Hirschsprung disease and anorectal malformations in the newborn to ulcerative colitis, familial polyposis and bowel emergencies in older children. Each condition has its own operation, and the long-term goal is the same for all of them, normal bowel control in a growing child. In Hirschsprung disease, a review of 792 children found that the transanal pull-through shortened the hospital stay by seven days and lowered soiling and constipation compared with the older abdominal operations (Chen and colleagues, Journal of Pediatric Surgery, 2013). For children who need the colon removed, a review of 763 young patients found pouch loss in 10.6 percent of those with ulcerative colitis and 1.5 percent of those with polyposis (Drews and colleagues, Journal of Pediatric Surgery, 2019). This page explains the main conditions, the operations, staged surgery and stomas, enterocolitis, bowel management, emergencies, and how families from abroad arrange pediatric colon surgery at Biruni Hospital in Istanbul.

What the operations cover

Children are not small adults. Their colon surgery is planned around growth, toilet training, school and the years until adulthood.

Many of these conditions are found in the first days of life, and early referral to a pediatric surgeon shapes the result.

Hirschsprung disease

The pull-through operation

The pull-through removes the bowel without nerve cells and brings healthy bowel down to just above the anus, keeping the sphincter muscles intact.

Long segment disease adds a laparoscopic step to free the colon from above.

Enterocolitis after Hirschsprung surgery

Total colonic disease carries the highest risk, 26.1 percent before surgery.

At home

Anorectal malformations

The type of malformation and the quality of the sacrum and spine predict future bowel control better than any single test.

Rebuilding the anus

• Closing the fistula.
• Placing the rectum in the center of the sphincter muscle complex, where the muscles can squeeze it shut.
• Creating a new anus of the right size for age.

Laparoscopic help is added when the rectum sits high, near the bladder neck.

Bowel management

Surgery does half the work.

Many children after anorectal malformation repair or Hirschsprung pull-through stay constipated or soil their underwear, and a structured bowel management program keeps them clean and in normal underwear at school, with a daily enema, a laxative adjusted week by week against abdominal X-rays, fiber and diet, all planned by the surgical team and the family together. A systematic review of programs run by video and telephone found that more than three quarters of families were satisfied, that bowel scores and quality of life improved, and that laxative use fell (Bokova and colleagues, Children, 2024). For older children who manage the enemas themselves, a small channel to the appendix, the Malone procedure, lets them flush the colon from above while sitting on the toilet. Families who live far away gain the most from this model.

We start it before school age.

Most families reach the goal, a clean child at school, within the first week of an intensive program.

Ulcerative colitis and polyposis

When surgery is needed

Familial adenomatous polyposis causes hundreds of colon polyps that turn into cancer without treatment. Colectomy is planned in the teenage years according to the number and size of polyps, with yearly colonoscopy until then.

Staged operations

A temporary stoma

• Our stoma nurses teach parents bag changes, skin care and the warning signs of problems before discharge.
• Babies feed, grow, crawl and bathe with a stoma.
• Older children attend school, swim with a waterproof cover and take part in sport.

Bowel emergencies

Green vomiting in a baby is a surgical emergency until proven otherwise.

Our neonatal and pediatric intensive care units support these children before and after surgery.

Laparoscopic and transanal surgery

The approach follows the condition, the child's size and earlier operations. Scar size never comes before safety or function.

Preparing your child

Children cope better when they know what to expect.

Toddlers and school children understand simple words, a tummy operation, a bag for a while, a doctor checking the bottom, and our play specialists use dolls with stomas and drawings to explain each step, while teenagers with colitis or polyposis join every discussion, see the stoma nurse before surgery and meet the dietitian to plan eating after the pouch is made. Parents stay with the child during induction of anesthesia and in the room throughout the stay.

Honest answers build trust.

For families from abroad

Stoma supplies for the first weeks are given at discharge, with brand names so you can buy the same products at home.

Cost

What changes the price

We send a written quote after reviewing reports and imaging, before you travel.

Prices are not published because each child's plan differs in the number of stages, the days in intensive care and the supplies needed after discharge.