title: The percutaneous cecostomy tube in the management of fecal incontinence in children.
abstract: OBJECTIVE
  To retrospectively evaluate experience with percutaneous cecostomies and their long-term outcomes.
  
  
  METHODS
  Between June 1994 and March 2009, 290 patients (mean age, 10.1 y) with fecal incontinence underwent percutaneous cecostomy tube placement and subsequent tube management. Technical success, procedural complications, and long-term follow-up until March 2012 were evaluated.
  
  
  RESULTS
  A cecostomy was successfully placed in 284 patients (98%), and 257 of 280 patients (92%) underwent a successful exchange to a low-profile tube. A total of 1,431 routine exchanges to low-profile tubes were reviewed in 258 patients (mean, 1.6 ± 1.3 routine tube changes per 1,000 days). Eighty-five patients (29%) experienced one or more early problems after cecostomy, and 10 (3%) had major complications. In the total 463,507 tube-days, 938 late problems were noted: 917 (98%) minor and 22 (2%) major. Forty patients had the cecostomy catheter removed and 141 "graduated" to an adult health care facility.
  
  
  CONCLUSIONS
  The percutaneous cecostomy procedure provides a safe management option for fecal incontinence in the pediatric population.
authors.affiliation: Faculty of Health Sciences, School of Medicine, Trinity College, Dublin, Ireland; Research Institute, Hospital for Sick Children.
authors.forename: Waqas Ullah
authors.initials: WU
authors.lastname: Khan
authors.affiliation: Department of Diagnostic Radiology, Kingston General Hospital, Kingston, Ontario, Canada.
authors.forename: Janakan
authors.initials: J
authors.lastname: Satkunasingham
authors.affiliation: Department of Family and Community Medicine, University of Toronto.
authors.forename: Rahim
authors.initials: R
authors.lastname: Moineddin
authors.affiliation: Department of Arts and Science, University of Toronto.
authors.forename: Irfan
authors.initials: I
authors.lastname: Jamal
authors.affiliation: Department of Immunology, University of Toronto; Campbell Family Institute for Breast Cancer Research, University Health Network, Toronto.
authors.forename: Samia
authors.initials: S
authors.lastname: Afzal
authors.affiliation: Department of Diagnostic Imaging, Hospital for Sick Children; Diagnostic Imaging, Scarborough Centenary Hospital, Scarborough, Toronto, Ontario, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Chait
authors.affiliation: Department of Diagnostic Imaging, Hospital for Sick Children.
authors.forename: Dimitri
authors.initials: D
authors.lastname: Parra
authors.affiliation: Department of Diagnostic Imaging, Hospital for Sick Children.
authors.forename: Joao G
authors.initials: JG
authors.lastname: Amaral
authors.affiliation: Department of Diagnostic Imaging, Hospital for Sick Children.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Temple
authors.affiliation: Department of Diagnostic Imaging, Hospital for Sick Children. Electronic address: tud17442@temple.edu.
authors.forename: Bairbre L
authors.initials: BL
authors.lastname: Connolly
mesh_terms: D000293:Adolescent; D015984:Causality; D002431:Cecostomy / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005242:Fecal Incontinence / Q000453:epidemiology* / Q000628:therapy*; D005260:Female; D005334:Fever / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D009864:Ontario / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome