Evaluation of Postoperative Outcomes and Rehabilitation Strategies in Pediatric Ileostomy Care

Abstract

Objective. This study aimed to assess and compare the effectiveness of different management strategies for pediatric patients with ileostomies, focusing particularly on how a comprehensive rehabilitation program influences postoperative complications and recovery outcomes.

Methods. Clinical data from 126 children who underwent ileostomy between 2014 and 2024 were retrospectively and prospectively analyzed. The control group (n=71) comprised patients managed from 2014–2019 using conventional care protocols, whereas the main group (n=55) received an optimized rehabilitation-based protocol starting in 2020. The improved approach included structured education for parents and patients, personalized stoma care, the use of combined antiseptics and protective films, absorbent dressings, low-intensity laser therapy, and tailored nutritional support. Early and late stoma complications, systemic morbidity, hospital stay, and reconstructive surgery rates were compared. Statistical significance was defined as p<0.05.

Results. Early stoma-related complications were reported in 53.5% of the control group and 27.3% of the main group (p=0.003). Systemic complications declined from 46.5% to 25.5% (p=0.016), while severe complications (Clavien–Dindo grades III–V) were notably higher in the control group (49.3% vs. 14.6%, p=0.002). Late complications decreased from 40.0% to 19.2% (p=0.017), and peristomal skin disorders fell from 41.7% to 21.2% (p=0.015). The mean hospital stay was shorter in the main group (11.5 ± 0.35 vs. 13.2 ± 0.5 days, p<0.001). Additionally, the frequency of timely reconstructive surgery increased, while persistent stoma function was more common in the control group (16.7% vs. 3.8%).

Conclusion. Implementing a comprehensive rehabilitation protocol that integrates advanced local and systemic therapeutic measures substantially reduces postoperative morbidity, accelerates recovery, shortens hospitalization, and improves long-term surgical outcomes in pediatric ileostomy patients.