WOFAPS 2025 8th World Congress of Pediatric Surgery

Ana Ramirez Calazans, Francisco Javier Murcia Pascual, Alberto Parente Hernandez, Rosa María Paredes Esteban

Hospital Universitario Reina Sofía- Córdoba- Spain

INTRODUCTION

To present our experience in modifying the approach and location of ostomies in patients with anorectal malformation (ARM) in order to avoid possible complications associated with this procedure.

MATERIAL AND METHODS

Retrospective review of patients diagnosed with ARM in whom a modified approach for colostomy was performed in the last 18 months in our center.

RESULTS

6 patients with ARM, 3 male with recto-urethral fistula and 3 female (1 without fistula, 1 with vestibular fistula and 1 cloaca). Mean gestational age of 36.1 weeks (31-39 weeks) and mean birth weight of 2658 g (1660-3550g). All colostomies were carried out on the 2nd day of life by performing an infraumbilical median laparotomy and divided colostomy at the level of mobile distal portion of descending colon with exteriorization of the proximal ostomy in the left lower quadrant and mucosal fistula at the distal end of the laparotomy incision. No patient had surgical wound complications or ostomy prolapse during follow-up. No patient had problems with the placement and handling of the bag in relation to the surgical wound.

CONCLUSIONS

The modification of the surgical approach and the location of the mucosal fistula has proven to be a safe and effective procedure, reducing the number of associated complications, such as infection or surgical wound dehiscence, as well as reducing the risk of urinary infection or distal impaction due to the passage of feces through the distal ostomy.