Gonca Gerçel, Mustafa Azizoglu, Esra Karakas, Toni Risteski, Maria Escolino, Luis De La Torre
Introduction
The optimal type of colostomy for patients with anorectal malformations (ARM) remains unclear. We conducted a systematic review and meta-analysis to compare the clinical outcomes of loop colostomies (LC) versus divided colostomies (DC) in patients with ARM.
Methods
After review registration (PROSPERO: CRD42024513335), we searched multiple databases for comparative studies on LCs and DCs in patients with ARMs. Gray literature was sought. The complications examined included stoma prolapse, urinary tract infection (UTI), skin excoriation, stoma retraction, parastomal hernia, wound infection rate, and stoma stricture. Three reviewers independently assessed the eligibility and quality of the included studies. Meta-analysis of selected complications was performed using Revman 5.4, with p < 0.05 considered significant.
Results
Eleven studies were included in the analysis, incorporating a total of 2550 neonates with ARMs, of which 1147 underwent LCs and 1403 underwent DCs. The meta-analysis revealed no significant differences between the two groups in the incidence of stoma prolapse (OR: 1.55, 95 % CI: 0.63 to 3.79; p = 0.34), UTIs (OR: 1.78, 95 % CI: 0.50 to 6.36; p = 0.38), skin excoriation (OR: 1.26, 95 % CI: 0.68 to 2.34; p = 0.46), stoma retraction (OR: 0.79, 95 % CI: 0.09 to 6.64; p = 0.83), parastomal hernia (OR: 0.99, 95 % CI: 0.22 to 4.48; p = 0.99), wound infection (OR: 0.35, 95 % CI: 0.10 to 1.20; p = 0.10), and stoma stricture (OR: 0.70, 95 % CI: 0.22 to 2.18; p = 0.53).
Conclusions
The findings suggest that LCs and DCs are viable options for fecal diversion, presenting similar risks and benefits. The choice between these techniques should consider individual patient characteristics and surgical expertise.
Type: video · 0 min · posted 2025-04-29 Canonical: https://library.globalcastmd.com/watch/comparing-loop-and-divided-colostomy-for-anorectal-malformation-a-systematic-review-and-meta-analysis-10428 ## Chapters - [0:01](https://library.globalcastmd.com/watch/comparing-loop-and-divided-colostomy-for-anorectal-malformation-a-systematic-review-and-meta-analysis-10428?t=1) Loop vs Divided Colostomy in Anorectal Malformation ## Statements - "The systematic review and meta-analysis compared clinical outcomes of loop colostomies versus divided colostomies in neonates with anorectal malformations" — Lizzie Lee (clinical) [0:10](https://library.globalcastmd.com/watch/comparing-loop-and-divided-colostomy-for-anorectal-malformation-a-systematic-review-and-meta-analysis-10428?t=10) - "The review included 11 retrospective cohort studies" — Lizzie Lee (epidemiological) [0:19](https://library.globalcastmd.com/watch/comparing-loop-and-divided-colostomy-for-anorectal-malformation-a-systematic-review-and-meta-analysis-10428?t=19) - "There were no significant differences between the two colostomy types in terms of complications such as stoma prolapse, urinary tract infections, and wound infections" — Lizzie Lee (clinical) [0:23](https://library.globalcastmd.com/watch/comparing-loop-and-divided-colostomy-for-anorectal-malformation-a-systematic-review-and-meta-analysis-10428?t=23) - "Both colostomies are good options for fecal diversion, with the choice depending on individual patient factors and surgical expertise" — Lizzie Lee (opinion) [0:31](https://library.globalcastmd.com/watch/comparing-loop-and-divided-colostomy-for-anorectal-malformation-a-systematic-review-and-meta-analysis-10428?t=31) ## Transcript Which colostomy is best in pediatric patients with anorectal malformation? I'm Lizzie Lee from Cincinnati Children's Hospital, and this is an article you should know about. The systematic review and meta-analysis compared clinical outcomes of loop colostomies versus divided colostomies in neonates with anorectal malformations. This review included 11 retrospective cohort studies. There were no significant differences between the two colostomy types in terms of complications such as stoma prolapse, urinary tract infections, and wound infections. Therefore, both colostomies are good options for fecal diversion, with the choice depending on individual patient factors and surgical expertise. Let us know what you think in the comments below and stay tuned for more articles that you should know about. --- Not medical advice · citation policy: https://library.globalcastmd.com/ai