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Abstract
Purpose: Pediatric stomas are often temporary, necessitating techniques that ensure ease of management, minimal complications, and superior cosmetic outcomes. This study evaluates the safety, efficacy, and cosmetic results of umbilical loop stomas compared to conventional abdominal stomas in a tertiary care center in Pakistan.
Methods: We conducted a comparative cohort study of 96 pediatric patients who underwent stoma construction between March 2018 and March 2025. The umbilical stoma group comprised 58 patients, while 38 underwent conventional abdominal stoma creation. We compared perioperative parameters, complications, and cosmetic outcomes using the Manchester Scar Scale (MSS) and Patient and Observer Scar Assessment Scale (POSAS).
Results: The two groups showed comparable complication rates (umbilical 12.1% vs. conventional 13.2%; P = 0.88). No emergency surgical interventions were required in either group. Cosmetic outcomes were significantly superior in the umbilical group: MSS scores (8.31 ± 1.92 vs. 16.58 ± 3.14; P < 0.001), POSAS observer scores (9.62 ± 2.41 vs. 22.15 ± 7.38; P < 0.001), and POSAS patient scores (10.68 ± 1.52 vs. 22.87 ± 7.51; P < 0.001). Parents reported high satisfaction with umbilical stoma management and the concealed final scar.
Conclusions: Umbilical loop stomas represent a safe and cosmetically superior alternative to conventional abdominal stomas in appropriately selected pediatric patients. With careful patient selection and meticulous technique, this approach offers excellent functional outcomes while preserving body image—a critical consideration for children's long-term psychological well-being.