Umbilical site for temporary colostomy in anorectal malformations: is it cosmetically preferable?

Abstract

Purpose In an attempt to minimize the scars and improve the cosmetic outcome in children, the umbilical site has been chosen for colostomy formation in patients with anorectal malformations.
Methods A retrospective review of the medical records of patients who had undergone umbilical colostomy with anorectal malformations from January 2006 to January 2012 was carried out. These patients were reviewed to evaluate intraoperative or postoperative complications, functional outcome, as well as cosmetic appearance after colostomy reversal.
Results A total of 105 patients with anorectal malformations underwent temporary umbilical colostomy. There were 43 boys and 62 girls. The age at colostomy formation ranged from 2 days to 12 months (mean 18 days). The mean operating time was 41 min. The mean follow-up period was 38.3 months (range, 6–72 months). Peristomal skin excoriations were the most common complication, occurring in 15 patients (14%). Partial retraction occurred in three patients. None of the patients developed stenosis or prolapse. Surgical revision of the colostomy was not required in any of the cases. All umbilical colostomies were reversed, with no postoperative complications such as wound infection, incisional hernia, or bowel obstruction. The cosmetic appearance after colostomy closure was similar to that of a normal umbilicus.
Conclusion The use of the umbilical site for temporary colostomy in neonates and infants with anorectal malformations is feasible and efficient functionally, and after stoma reversal, appears to be cosmetically superior to stomas created in other parts of the abdomen. 

Keywords: anorectal malformations, colostomy, umbilical ostomy