title: Cecostomy in children with defecation disorders.
abstract: Administration of antegrade enemas through a cecostomy is a therapeutic option for children with severe defecation disorders. The purpose of this study is to report our 4-year experience with the cecostomy procedure in 31 children with functional constipation (n = 9), Hirschsprung's disease (n = 2), imperforate anus (n = 5), spinal abnormalities (n = 8), and imperforate anus in combination with tethered spinal cord (n = 7). Data regarding complications, antegrade enemas used, symptoms, and quality of life were retrospectively obtained. Placement of cecostomy tubes was successful in 30 of 31 patients. Soiling episodes decreased significantly in children with functional constipation (P = 0.01), imperforate anus (P < 0.01), and spinal abnormalities (P = 0.04). Quality of life improved in patients with functional constipation and imperforate anus. No difference in complications was found between percutaneous and surgical placement. Use of antegrade enemas via cecostomy improved symptoms and quality of life in children with a variety of defecation disorders.
authors.affiliation: Divisions of Pediatric Gastroenterology, Columbus Children's Hospital, Ohio State University College of Medicine and Public Health, Columbus, Ohio 43205, USA. mousah@pediatrics.ohio-state.edu
authors.forename: Hayat M
authors.initials: HM
authors.lastname: Mousa
authors.forename: Maartje M
authors.initials: MM
authors.lastname: van den Berg
authors.forename: Donna A
authors.initials: DA
authors.lastname: Caniano
authors.forename: Mark
authors.initials: M
authors.lastname: Hogan
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Lorenzo
authors.forename: John
authors.initials: J
authors.lastname: Hayes
mesh_terms: D000293:Adolescent; D002431:Cecostomy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000523:psychology / Q000601:surgery*; D005242:Fecal Incontinence / Q000523:psychology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome