title: Neonatal stomas: does a separate incision avoid complications and a full laparotomy at closure?
abstract: OBJECTIVE
  Enterostomy formation is a common outcome in emergency neonatal laparotomy. No consensus exists regarding optimal stoma site. This study aims to identify incidence of complications and closure details related to position of stomas.
  
  
  METHODS
  This study is a retrospective case note review of emergency neonatal enterostomy formation over 11 years at a single institution. Patients were separated into two groups: stomas created through the laparotomy wound and stomas created through a separate incision. Demographic details, complications and closure details were ascertained. Differences between groups were analysed (Mann-Whitney test for continuous variables, Chi-squared test or Fisher's exact test for categorical variables).
  
  
  RESULTS
  One hundred and thirteen stoma formations were examined in 106 patients (71 within laparotomy wound, 42 through a separate incision). Age, gestation, weight, wound-related and stoma-related complications were not significantly different between the groups. A trend towards a higher rate of full laparotomy at closure with stomas through the wound (p = 0.09) was seen. If stomas were sited adjacently, there was no difference in avoidance of full laparotomy at closure (p = 0.97).
  
  
  CONCLUSIONS
  Stomas sited adjacently within the laparotomy wound are not related to increased complications and offer the same advantage of circumexcision at closure as stomas sited through a separate wound, without an additional abdominal wound.
authors.affiliation: Royal Hospital for Sick Children, Glasgow, UK. rkronfli@doctors.net.uk
authors.forename: Rania
authors.initials: R
authors.lastname: Kronfli
authors.forename: Kirsty
authors.initials: K
authors.lastname: Maguire
authors.forename: Gregor Murray
authors.initials: GM
authors.lastname: Walker
mesh_terms: D001656:Biliary Atresia / Q000601:surgery; D004630:Emergencies; D020345:Enterocolitis, Necrotizing / Q000601:surgery; D004766:Enterostomy / Q000379:methods*; D006627:Hirschsprung Disease / Q000601:surgery; D006801:Humans; D045823:Ileus / Q000601:surgery; D007231:Infant, Newborn; D007813:Laparotomy; D008470:Meconium; D011183:Postoperative Complications; D012189:Retrospective Studies