Purpose:
Despite advancements in surgical techniques and stoma care products, stoma-related complications remain a significant concern in pediatric patients. This study aimed to evaluate the incidence of stoma complications and to identify potential risk factors, including patient diagnosis, nutritional status, urgency of stoma creation, and stoma type.
Methods:
A retrospective review was conducted on pediatric patients aged 0–18 years who underwent enterostomy reversal between 2019 and 2025. Patients with necrotizing enterocolitis, anal atresia, Hirschsprung’s disease, rectal disorders, meconium ileus, cystic fibrosis, volvulus, intestinal atresia, and intestinal perforation were included. Patients who underwent gastrostomy or jejunostomy were excluded. Data on demographics, underlying disease, comorbidities, stoma type and level, surgical urgency (elective or emergency), and complications (anastomotic leak, prolapse, severe peristomal dermatitis, obstruction, perforation, wound infection) were collected. Statistical analysis was performed using univariate and multivariate logistic regression (significance set at p ≤ 0.05).
Results:
A total of 270 patients were included in the study. Of these, 68.1% underwent stoma creation under emergency conditions. The most frequent indication was necrotizing enterocolitis (38.5%, n=104). Stoma-related complications occurred in 32.6% (n=88) of patients. The most common complications were peristomal dermatitis (10%, n=27), stoma prolapse (7.4%, n=20), and wound dehiscence (6.3%, n=17). There were no significant differences in complication rates based on demographic factors such as sex, gestational age, birth weight, or comorbidities. Complications were significantly more frequent in patients who underwent emergency stoma creation (p ≤ 0.05). Although colostomy patients had a higher complication rate, this difference was not statistically significant (p ≥ 0.05). Reoperation was required in 41 patients with stoma-related complications.
Conclusion:
Peristomal dermatitis and wound dehiscence were the most frequent complications in pediatric stoma patients. Emergency stoma creation is a significant risk factor for complications. Elective stoma creation and appropriate stoma care are essential to reduce complication rates.
Keywords: Pediatric stoma, stoma complications, emergency surgery, necrotizing enterocolitis, stoma care
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