The Percutaneous Cecostomy Tube in the Management of Fecal Incontinence in Children

Abstract

PurposeTo retrospectively evaluate experience with percutaneous cecostomies and their long-term outcomes. Materials and MethodsBetween 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. ResultsA 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. ConclusionsThe percutaneous cecostomy procedure provides a safe management option for fecal incontinence in the pediatric population.