Laparoscopically assisted versus open colostomy for anorectal malformation: a comparison of postoperative outcomes

Introduction Colostomy is a common surgical procedure in neonates with anorectal malformations (ARM). The procedure is associated with a risk of complications, prompting the development of a laparoscopically assisted approach as an attempt to minimize their occurrence. However, evidence on the efficacy of the laparoscopic approach to reduce postoperative complications is limited. The aim of this study was to compare postoperative outcomes in ARM patients undergoing laparoscopically assisted versus open colostomies. Method Medical records of all newborns with ARM who underwent a colostomy procedure at the Karolinska University Hospital between 2012 and 2022 were retrospectively reviewed. Patients were divided into two groups based on whether the colostomy was laparoscopy-assisted or fashioned through a limited open incision at the site of the stoma. Postoperative outcomes, including time to first oral feeding, length of hospital stay, and complications classified according to Clavien-Madadi, were compared between the two groups. Result 45 patients were included, of which 14 underwent laparoscopically assisted colostomy. Two (14 %) of patients with laparoscopically assisted and eight (26%) patients with open colostomy had postoperative complications classified as Clavien-Madadi >1b, p=0.5. There were no significant differences in the severity of postoperative complications between the two groups. The median time to first oral feeding was zero days and the length of hospital stay for the entire study population was eight days, with no significant difference between the two procedures. Discussion Laparoscopically assisted colostomy has a similar risk of postoperative complications as open colostomy in patients with ARM.