Abstract No. 437 Fluoroscopically guided, percutaneously placed cecostomies versus surgically placed cecostomies in adult patients: a safety comparison

Abstract

To compare the safety of fluoroscopically guided, percutaneously placed cecostomies versus surgically placed cecostomies in adult patients with colonic dysmotility. A retrospective query of the electronic medical record identified all adult patients who had cecostomies placed at a single, large academic medical center from December 2004 through December 2019. Patients without adequate documentation were excluded. The primary outcomes were cecostomy-related adverse events and technical success. Adverse events were categorized per the Society of Interventional Radiology (SIR) Adverse Event Classification and defined as either early or late based on the dates of cecostomy placement and exchange. Any complications unrelated to the cecostomy placement were excluded. Univariate and multivariate analysis was used to assess the association between procedural type and postprocedural complications. 67 adults patients underwent cecostomy placement for refractory colonic dysmotility with 50/67 (74.6%) placed percutaneously. The most common indication for cecostomy was neurogenic bowel associated with spina bifida (18/67; 27%). Four (5.9%) patients received venting cecostomy in the setting of colonic pseudo-obstruction. The median LOS for patients who had surgically placed cecostomies (SPC) was 6 days (IQR 5,10 days) while the median length of stay for patients who had fluoroscopically guided, percutaneously placed cecostomies (PPC) was 2 days (IQR 1,4 days) (P = 0.0003). Five SPC patients and 21 PPC patients and had early complications. SPC patients were 22.4 times more likely to experience a late complication than those in the PPC group. There was no difference in the severity of the complications between the two groups. Fluoroscopy-guided, percutaneous cecostomy placement is a minimally invasive alternative to surgery with shorter LOS, fewer complication rates, and similar complication severity.