Tube sigmoidostomy: a modification of the antegrade colonic evacuation

Abstract

This article reports on 2 children with spina bifida and fecal incontinence in whom the appendix was not available for a Malone appendocecostomy. The authors considered a tubularized cecal valve but decided against this option because of the potential time delay between enema and evacuation. Rather, the same tubularization technique was applied to the sigmoid colon, constructing a tube sigmoidostomy around a 12F Foley catheter. With a clinical review period of between 6 and 17 months, the 2 patients were able to self-catheterize and achieve a satisfactory result with a saline enema within 20 minutes. Both patients, previously totally incontinent, considered themselves usually continent using this technique. This technique would seem to be a useful alternative to other established methods.—A.J.A. Holland