Laparoscopic colostomy for colorectal problems in children

Abstract

Purpose

To describe our experience in laparoscopic colostomy with separated stomas for colorectal issues in pediatric patients.

Methods

This prospective cohort, single-institution study included patients aged 0–18 years who exhibited colorectal problems requiring a colostomy and who were managed at a tertiary-level care hospital between October 2023 and September 2024.

Results

Fourteen patients were analyzed. Eleven (78 %) patients with anorectal malformation (ARM), 2 (14 %) with acquired rectal fistula, and 1 (7 %) with recurrent rectal fistula due to suspected inflammatory bowel disease. In total, 7 (63 %) of 11 patients with ARM underwent diversion during the neonatal period. Further, 4 (36 %) patients had diverted due to megarectum later in life. All patients underwent laparoscopic colostomy with separated stomas. The mean surgical duration was 114 (78–141) minutes. Enteral feeding was started at a mean of 1.7 [1–3] days postoperatively. The median length of hospital stay was 10.4 ([1]-51) days. There were no cases of stoma prolapse, wound infection, or skin excoriation. One (7 %) patient with a recto-vestibular fistula developed mucosal fistula stenosis at 90 days after colostomy.

Conclusions

Laparoscopic colostomy with separate stomas in children with colorectal problems is a safe, reproducible technique, with a lower risk of complications and with greater advantages compared with the open technique.