Neonatal single-site divided colostomy in anorectal malformation

Area of Science:

• Pediatric Surgery
• Neonatal Care
• Gastrointestinal Surgery

Background:

• Anorectal malformations (ARM) are complex congenital anomalies requiring surgical intervention.
• Colostomy is a common procedure in managing ARM, but various techniques exist.
• Optimizing stoma creation is crucial for minimizing complications in neonates.

Purpose of the Study:

• To evaluate the outcomes of a single-site divided colostomy technique in neonates diagnosed with anorectal malformations (ARM).
• To assess the safety and efficacy of this specific surgical approach for ARM management.
• To identify and classify postoperative complications associated with this procedure.

Main Methods:

• Retrospective review of neonates with ARM who underwent colostomy between 2012 and 2024.
• Detailed description of the single-site divided colostomy technique, including proximal limb elevation and distal mucous fistula management.
• Complication classification using the Clavien-Mendadi (CM) system.

Main Results:

• Sixty-one neonates were included, with 79% being male, operated at a median age of 1 day.
• Postoperative complications occurred in 12% of patients, with 3% experiencing severe (CM IIIb) complications like parastomal hernia.
• Urinary tract infections (CM II) were the most frequent complication (10%), with other issues including granulation tissue and wound infections.

Conclusions:

• Single-site divided colostomy is a safe and effective surgical option for neonates with ARM.
• The technique is associated with predominantly minor complications and minimal scarring.
• No instances of fecal overflow were observed, indicating good stoma function.