UK neonatal stoma practice: a population study

Area of Science:

• Pediatric Surgery
• Neonatal Care
• Clinical Trial Feasibility

Background:

• Optimal timing for neonatal stoma closure remains undetermined.
• Previous calls for a comparative trial of early versus late stoma closure exist.
• Trial feasibility hinges on eligible patient population and stakeholder acceptance.

Purpose of the Study:

• To assess current UK practices for neonatal stoma surgery.
• To characterize neonates undergoing stoma formation and closure.
• To determine the feasibility of a clinical trial on stoma closure timing.

Main Methods:

• Retrospective cohort study utilizing three UK national databases (NNRD, BAPS-CASS, HES-APC).
• Inclusion criteria: neonates undergoing stoma surgery (excluding anorectal malformations and Hirschsprung's disease).
• Data analyzed for patient characteristics, stoma duration, and closure timing indicators (2011-2019).

Main Results:

• A substantial cohort of 1830-2477 neonates identified across databases.
• Median stoma duration ranged from 57 to 78 days.
• Earlier closure (<9 weeks) associated with less preterm infants, higher birth weight, and increased stoma complications.

Conclusions:

• Sufficient UK neonates undergo stoma formation to support a clinical trial.
• Stoma closure is generally performed around 2 months post-formation.
• Clinical stability, gestational age, weight, and stoma complications influence closure timing, suggesting optimization opportunities.