COLOSTOMY IN INFANTS — INDICATIONS, SURGICAL APPROACHES, COMPLICATIONS, AND CURRENT OUTCOMES: A NARRATIVE REVIEW

Abstract

Infant colostomy remains an essential surgical procedure in neonatal and pediatric surgical practice, serving both temporary and definitive roles in the management of various congenital and acquired gastrointestinal disorders. Common indications include anorectal malformations, Hirschsprung disease, necrotizing enterocolitis, intestinal perforation, meconium disorders, and traumatic bowel injuries. Several colostomy techniques have been described in infants, including loop, divided, and double-barrel colostomies, each with distinct advantages, limitations, and complication profiles. Postoperative complications such as prolapse, skin excoriation, stenosis, retraction, parastomal hernia, and electrolyte imbalance remain common and may significantly affect nutritional status, growth, and quality of life. Furthermore, stoma care in infants presents unique challenges because of delicate skin, small abdominal surface area, and dependence on caregivers. This narrative review summarizes the current indications, operative techniques, perioperative management strategies, complications, and outcomes associated with infant colostomy.  Recent advances in neonatal surgical care, stoma appliances, minimally invasive approaches, and enhanced recovery strategies have improved postoperative outcomes.