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ORIGINAL RESEARCH article

Front. Surg.
Sec. Pediatric Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1524404

From colostomy creation to full enteral feeding in neonates with an anorectal malformation: evaluating the role of central venous access

Provisionally accepted
Demi Huijgen Demi Huijgen *Irene K. Schokker-van Linschoten Irene K. Schokker-van Linschoten Hendt P. Versteegh Hendt P. Versteegh Cornelius E.J. Sloots Cornelius E.J. Sloots
  • Department of Pediatric Surgery, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands

The final, formatted version of the article will be published soon.

    PurposeAfter creating a colostomy in newborns with anorectal malformations (ARMs), reaching full enteral feeding may take longer than expected, resulting in an unanticipated period of starvation. This retrospective cohort study aimed to evaluate the postoperative course regarding enteral feeding tolerance and the necessity for a central venous access device (CVAD) after colostomy formation in newborns with ARMs. MethodsThe files of neonates with ARMs who underwent colostomy formation between January 2014 and August 2023 were reviewed. The primary outcome was the postoperative tolerance of enteral feeding. Secondary outcomes were the need for a CVAD and CVAD-related complications. Results Thirty-four neonates with an ARM underwent colostomy formation. Enteral feeding was initiated on median postoperative day two (IQR 1-2). Full enteral feeding was reached on median postoperative day six (IQR 4-8). In nine neonates (26.5%), it took more than seven postoperative days to reach full enteral feeding, of whom 7 (77.8%) had one or more comorbidities that could affect neonatal feeding tolerance. A CVAD was placed in 17 neonates (50%), of whom four (23.5%) needed additional general anesthesia for its placement. There were one or more CVAD-related complications in seven of 17 (41.2%) neonates, mainly involving suspicion of mild catheter-related infections. ConclusionsThe majority of neonates undergoing colostomy formation for an ARM require more than five days to achieve full enteral feeding. It is recommended to bridge this period of inadequate feeding with either fluids or parenteral nutrition by inserting a CVAD during colostomy formation, particularly for those with comorbidities affecting neonatal feeding tolerance.

    Keywords: anorectal malformation, Neonatal surgery, Colostomy, nutrition, Central venous catheter, Peripherally

    Received: 07 Nov 2024; Accepted: 16 Jan 2025.

    Copyright: © 2025 Huijgen, Schokker-van Linschoten, Versteegh and Sloots. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Demi Huijgen, Department of Pediatric Surgery, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, Netherlands

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