Neonatal single-site divided colostomy in anorectal malformation

Signe Olsbø; Astrid Ingeborg Austrheim; Anders Telle Hoel; Kristin Bjørnland

doi:10.1007/s00383-026-06507-2

Neonatal single-site divided colostomy in anorectal malformation

Pediatr Surg Int. 2026 Jun 29;42(1):276. doi: 10.1007/s00383-026-06507-2.

Authors

Signe Olsbø^{1

2}, Astrid Ingeborg Austrheim^{3

4}, Anders Telle Hoel³, Kristin Bjørnland^{3

5}

Affiliations

¹ Department of Hepatic, Pancreatic and Pediatric Surgery, Oslo University Hospital, Oslo, Norway. signe.olsbo@gmail.com.
² Institute of Clinical Medicine, University of Oslo, Oslo, Norway. signe.olsbo@gmail.com.
³ Department of Hepatic, Pancreatic and Pediatric Surgery, Oslo University Hospital, Oslo, Norway.
⁴ Children's Surgical Department, Division of Pediatric Surgery, Oslo University Hospital, Oslo, Norway.
⁵ Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

Abstract

Purpose: To evaluate outcomes of a single-site divided colostomy in neonates with anorectal malformations (ARM).

Methods: A retrospective review was conducted of neonates with ARM undergoing colostomy creation between 2012 and 2024 at a tertiary referral center. The technique used a divided colostomy with the proximal limb raised ~ 1.5 cm above skin level and a narrowed distal mucous fistula within the same opening, allowing coverage with a single stoma bag. The distal bowel was irrigated at surgery. Complications were classified using the Clavien-Madadi (CM) system.

Results: Sixty-one patients (79% male) were included, operated at a median age of 1 (1-3) day. Postoperative complications occurred in 12 (20%) patients. Two (3%) had CM IIIb complications (parastomal hernia and misidentification of bowel limbs). Urinary tract infection (CM II) developed in 6 (10%) patients; three with rectourethral fistula (one with vesicoureteral reflux), two with cloaca, and one without a fistula. Additional complications included granulation tissue requiring treatment (1) and wound infections requiring antibiotics (3). Major dressing difficulties were reported in 5 (8%) patients, while 20 (33%) had minor to moderate issues managed conservatively.

Conclusion: Single-site divided colostomy is a safe technique with predominantly minor complications, minimal scarring, and no observed fecal overflow.

Keywords: Anorectal malformation; Neonatal colostomy; Stoma complications; Surgical outcomes.

MeSH terms

Anorectal Malformations* / surgery
Colostomy* / methods
Female
Humans
Infant, Newborn
Male
Postoperative Complications / epidemiology
Retrospective Studies
Treatment Outcome