Laparoscopically assisted versus open colostomy for anorectal malformations: a comparison of postoperative outcomes

TL;DR

This study compares laparoscopically assisted and open colostomy procedures in newborns with anorectal malformations and finds no significant difference in postoperative complications.

Contribution

The study introduces laparoscopically assisted colostomy as an alternative to open colostomy in anorectal malformations.

Findings

Laparoscopically assisted colostomy had a similar risk of postoperative complications as open colostomy.

No significant differences in complication severity were observed between the two groups.

Median hospital stay and time to first oral feeding were similar in both groups.

Abstract

Colostomy is a common procedure in neonates with anorectal malformations (ARM) but carries a risk of complications, prompting the development of a laparoscopically assisted approach to minimize them. This study aimed to compare postoperative outcomes in ARM patients undergoing laparoscopically assisted versus open colostomies.

Medical records of all newborns with ARM who underwent colostomy at Karolinska University Hospital between 2012 and 2022 were retrospectively reviewed. Patients were grouped based on whether the colostomy was laparoscopy-assisted or fashioned through a limited open incision at the stoma site. Postoperative outcomes, including time to first oral feeding, hospital stay, and complications according to Clavien-Madadi, were compared.

A total of 44 patients were included, of whom 14 underwent laparoscopically assisted colostomy. Among all patients, the median time to first oral feeding was zero days and the median hospital stay was eight days, with no significant group differences. Postoperative complications classified as Clavien–Madadi ≥ IB occurred in 2 patients (14%) in the laparoscopic group and 7 (23%) in the open colostomy group (p = 0.6). No significant differences in complication severity were observed.

Laparoscopically assisted colostomy has a similar risk of postoperative complications as open colostomy in patients with ARM.