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Surgery on Children

Surgery on Children Journal aims to publish issues related to Pediatric Surgery, Pediatric Neurosurgery, Pediatric Plastic Surgery, Pediatric Cardiovascular Surgery, Pediatric Orthopedic Surgery, Pediatric Vascular Surgery, Pediatric Gynecology and Obstetrics, Pediatric Ear Nose Throat, Ophthalmology, Pediatric Anesthesiology and Reanimation, Pediatric Urology, Pediatric Surgical Intensive Care Clinic, and other clinical surgery fields on children of the highest scientific and clinical value at an international level and accepts articles on these topics.

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Original Article
Beyond fecal diversion: stoma-related morbidity in a cohort of 318 children
Abstract
Aims: To evaluate complications occurring between intestinal stoma formation and closure in children and to identify demographic and clinical factors associated with their development.
Methods: This single-center retrospective study included 318 pediatric patients who underwent intestinal stoma formation between January 2019 and December 2025. Demographic and clinical characteristics and complications occurring before stoma closure were analyzed. Groups were compared using Pearson’s chi-square and Welch’s t-tests. Factors associated with complication development were evaluated using multivariable logistic regression.
Results: At least one stoma-related complication occurred in 105 patients (33.0%). Peristomal dermatitis was the most common complication (17.0%), followed by stoma prolapse (6.9%), wound dehiscence (6.3%), bleeding (1.9%), and adhesive/band-related ileus (0.9%). Complications were significantly more frequent following emergency than elective surgery (38.2% vs 21.4%; p=0.003). Patients who developed complications had significantly lower gestational age (37.8±4.2 vs 39.1±4.4 weeks; p=0.011) and birth weight (2360±480 vs 2510±310 g; p=0.004). Among 22 patients with stoma prolapse, eight required surgical intervention, whereas 14 were managed conservatively. In multivariable analysis, emergency surgery was associated with increased odds of complications (OR=2.26), while gestational age (OR=0.27) and birth weight (OR=0.85) showed inverse associations.
Conclusion: Stoma-related complications affect approximately one-third of pediatric patients, demonstrating substantial morbidity during the diversion period. Emergency surgery, lower gestational age, and lower birth weight were associated with complication development. These findings highlight the importance of risk-adapted surveillance focusing on stoma function, peristomal skin integrity, growth, and nutritional status, particularly in vulnerable children.

Keywords : Child, enterostomy, colostomy, ileostomy, postoperative complications

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Ethical Statement

The study was approved by the Clinical Researches Ethics Committee of Ankara Bilkent City Hospital (Date: 15.06.2026, Decision No: E2-26-368).

Informed Consent

This retrospective study used pre-existing anonymized patient data. No additional intervention was performed, and there was no direct patient contact. The study was approved by the Ethics Committee, and the requirement for written informed consent was waived by the ethics committee.

Author Contributions

Conceptualization: AUU, CİÖ; Design: AUU, CİÖ; Supervision: AUU, CİÖ; Materials: AUU, CİÖ; Data Collection and/or Processing: AUU, CİÖ; Analysis and/or Interpretation: AUU, CİÖ; Literature Review: AUU, CİÖ; Writing: AUU, CİÖ; Critical Review: AUU, CİÖ.

Conflict of Interest

The authors declare no conflicts of interest related to this study.

Financial Disclosure

The authors received no financial support for the conduct or publication of this research.


1. Steinau G, Ruhl KM, Hörnchen H, Schumpelick V. Enterostomy complications in infancy and childhood. Langenbecks Arch Surg. 2001; 386(5):346-349. doi:10.1007/s004230100243
2. Çiğdem MK, Onen A, Duran H, Öztürk H, Otçu S. The mechanical complications of colostomy in infants and children: analysis of 473 cases of a single center. Pediatr Surg Int. 2006;22:671-676. doi:10.1007/s00383-006-1718-4
3. Peña A, Migotto-Krieger M, Levitt MA. Colostomy in anorectal malformations: a procedure with serious but preventable complications. J Pediatr Surg. 2006;41(4):748-756. doi:10.1016/j.jpedsurg.2005.12.021
4. Vogel I, Eeftinck Schattenkerk LD, Venema E, et al. Major stoma related morbidity in young children following stoma formation and closure: a retrospective cohort study. J Pediatr Surg. 2022;57:402-406. doi:10.1016/j.jpedsurg.2021.11.021
5. Tan AYE, Deogracias JMC. Major stoma complications in pediatric patients in a tertiary hospital in a low-middle-income country: a retrospective cohort study. Pediatr Surg Int. 2024;40:208. doi:10.1007/s00383-024-05791-0
6. Wolf L, Gfroerer S, Fiegel H, Rolle U. Complications of newborn enterostomies. World J Clin Cases. 2018;6(16):1101-1110. doi:10.12998/wjcc.v6.i16.1101
7. Bethell G, Kenny S, Corbett H. Enterostomy-related complications and growth following reversal in infants. Arch Dis Child Fetal Neonatal Ed. 2017;102(3):F230-F234. doi:10.1136/archdischild-2016-311126
8. Aguayo P, Fraser JD, Sharp S, St Peter SD, Ostlie DJ. Stomal complications in the newborn with necrotizing enterocolitis. J Surg Res. 2009;157(2):275-278. doi:10.1016/j.jss.2009.06.005
9. Bælum JK, Rasmussen L, Qvist N, Ellebæk MB. Enterostomy complications in necrotizing enterocolitis (NEC) surgery, a retrospective chart review at Odense University Hospital. BMC Pediatr. 2019;19:110. doi:10.1186/s12887-019-1488-5
10. Chong C, van Druten J, Briars G, et al. Neonates living with enterostomy following necrotising enterocolitis are at high risk of becoming severely underweight. Eur J Pediatr. 2019;178(12):1875-1881. doi:10.1007/s00431-019-03440-6
11. WHO Multicentre Growth Reference Study Group. WHO Child Growth Standards: Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: methods and development. Geneva: World Health Organization; 2006.
12. Sarac F. Intestinal stoma types, indications and complications in pediatric patients: a three-year single-center experience with necrotizing enterocolitis as the leading indication. Med Bull Haseki. 2025;63(5):281-287. doi:10.4274/haseki.galenos.2025.80299
13. Massenga A, Chibwae A, Nuri AA, et al. Indications for and complications of intestinal stomas in the children and adults at a tertiary care hospital in a resource-limited setting: a Tanzanian experience. BMC Gastroenterol. 2019;19:157. doi:10.1186/s12876-019-1070-5
14. Alghamdi HA, Alqahtani MSM, Asiri HMM, et al. Investigating colostomy-related morbidity in children following stoma formation and closure in a tertiary hospital, Abha, Saudi Arabia: a retrospective cohort study 2024. BMC Pediatr. 2024;24:630. doi:10.1186/s12887-024-05089-z
15. O’Connor A, Sawin RS. High morbidity of enterostomy and its closure in premature infants with necrotizing enterocolitis. Arch Surg. 1998; 133(8):875-880. doi:10.1001/archsurg.133.8.875
16. Xu X, Zhou Y, Tan Z, et al. Risk factors for stoma and incision complications of enterostomy in children with very early-onset inflammatory bowel disease: a prospective cohort study. Eur J Pediatr. 2025;184:146. doi:10.1007/s00431-024-05952-2
17. Zeng Z, Hu Y, Hou S, Yang R, Shi Z, Li X. Risk factors for complications after infantile enterostomy: development of a clinical prediction model. Front Public Health. 2025;13:1566789. doi:10.3389/fpubh.2025.1566789
18. Klein T, Guarnizo-Diaz GS, Semaan A, Boemers TM, Vahdad RM. Colostomy complications in patients with anorectal malformations. Langenbecks Arch Surg. 2025;410:210. doi:10.1007/s00423-025-03795-5
19. Hamdi MA, Mohamed WM, Al-Ani UFT. The colostomy complications in anorectal malformation: a retrospective study. J Coloproctol. 2021; 41(3):286-288. doi:10.1055/s-0041-1730259
20. Johnson P. Intestinal stoma prolapse and surgical treatments of this condition in children: a systematic review and a retrospective study. Surg Sci. 2016;7:400-426. doi:10.4236/ss.2016.79057
21. Coletta R, Zulli A, O’Shea K, Mussi E, Bianchi A, Morabito A. Minimizing enterostomy complication in neonates, lessons learnt from three European tertiary centres. Children (Basel). 2022;9(2):162. doi:10.3390/children9020162
Article available in :
Volume 3, Issue 4, 2026
Page : 149-154
https://doi.org/10.51271/SOC-0088
Article Information
Received : 11 Eyl 2026
Accepted : 11 Eki 2026
Published : 20 Eki 2026
Corresponding Author :

Abdurrahman Urve Uzun: Gulhane Training and Research Hospital, Department of Pediatric Surgery, Ankara, Türkiye

[email protected]
Citation : Uzun AU, Öztorun Cİ. Beyond fecal diversion: stoma-related morbidity in a cohort of 318 children. Surg Child. 2026;3(4):149-154. doi:10.51271/SOC-0088

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