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Percutaneous cecostomy: 25-year two institution experience
Background Reports of technical success, adverse events, and long-term outcome of percutaneous cecostomy in children are limited. Objective To characterize technical success, 30-day severe adverse events, and long-term outcome of percutaneous cecostomy at two centers. Materials and methods A retrosp...
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| Published in: | Pediatric radiology 2024-06, Vol.54 (7), p.1137-1143 |
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| creator | James, Charles A. Hogan, Mark J. Seay, Ryan P. James, Luke T. Jensen, Hanna K. Kaukis, Nicholas A. Moore, Mary B. Braswell, Leah E. |
| description | Background
Reports of technical success, adverse events, and long-term outcome of percutaneous cecostomy in children are limited.
Objective
To characterize technical success, 30-day severe adverse events, and long-term outcome of percutaneous cecostomy at two centers.
Materials and methods
A retrospective review of hospital course and long-term follow-up (through May 2022) of percutaneous cecostomy tubes placed May 1997 to August 2011 at two children’s hospitals was used. Outcomes assessed included technical success (defined as successful tube placement into the colon allowing antegrade colonic enemas), length of stay, 30-day severe adverse events, surgery consults, surgical repair, VP shunt infection, ongoing flushes, tube removal, duration between maintenance tube exchanges, and deaths.
Results
A total of 215 procedures were performed in 208 patients (90 institution A, 125 institution B). Tubes were placed for neurogenic bowel (72.1%,
n
= 155) and functional constipation (27.9%,
n
= 60). Technical success was 98.1% (211/215) and did not differ between centers (
p
= 0.74). Surgical repair was required for bowel leakage in 5.1% (11/215) and VP shunt infection was managed in 2.1% (2/95). Compared to functional constipation, patients with neurogenic bowel had higher % tube remaining (65.3% [96/147] versus 25.9% [15/58],
p
|
| doi_str_mv | 10.1007/s00247-024-05936-2 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3050176123</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3050176123</sourcerecordid><originalsourceid>FETCH-LOGICAL-c326t-3e067b7d8eb2822aa4f0e764902bab8b31909ea2dfb7065b0ed3c4341b55f33b3</originalsourceid><addsrcrecordid>eNp9kE1PwzAMhiMEYmPwBzigSly4FJy4aZvd0MSXhAQHOEdN66JOWzuSVLB_T0bHhzhwsS358etXL2PHHM45QHbhAESSxaHEIBWmsdhhY56giLlS-e6vecQOnJsDAEqO-2yEeapQSBiz6SPZsvdFS13vopLKzvluuZ5GQsZrKmzk37qoaZ1vfO-bro3ofUW2obakQ7ZXFwtHR9s-Yc_XV0-z2_j-4eZudnkflyhSHyNBmpmsysmIXIiiSGqgLE0UCFOY3CBXoKgQVW0ySKUBqrBMMOFGyhrR4ISdDbor27325LxeNq6kxWIwrREk8CzlAgN6-gedd71tg7tApblSqLINJQaqtJ1zlmq9ss2ysGvNQW-S1UOyOhT9mawW4ehkK92bJVXfJ19RBgAHwIVV-0L25_c_sh_IdIJ2</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3068993973</pqid></control><display><type>article</type><title>Percutaneous cecostomy: 25-year two institution experience</title><source>Springer Nature</source><creator>James, Charles A. ; Hogan, Mark J. ; Seay, Ryan P. ; James, Luke T. ; Jensen, Hanna K. ; Kaukis, Nicholas A. ; Moore, Mary B. ; Braswell, Leah E.</creator><creatorcontrib>James, Charles A. ; Hogan, Mark J. ; Seay, Ryan P. ; James, Luke T. ; Jensen, Hanna K. ; Kaukis, Nicholas A. ; Moore, Mary B. ; Braswell, Leah E.</creatorcontrib><description>Background
Reports of technical success, adverse events, and long-term outcome of percutaneous cecostomy in children are limited.
Objective
To characterize technical success, 30-day severe adverse events, and long-term outcome of percutaneous cecostomy at two centers.
Materials and methods
A retrospective review of hospital course and long-term follow-up (through May 2022) of percutaneous cecostomy tubes placed May 1997 to August 2011 at two children’s hospitals was used. Outcomes assessed included technical success (defined as successful tube placement into the colon allowing antegrade colonic enemas), length of stay, 30-day severe adverse events, surgery consults, surgical repair, VP shunt infection, ongoing flushes, tube removal, duration between maintenance tube exchanges, and deaths.
Results
A total of 215 procedures were performed in 208 patients (90 institution A, 125 institution B). Tubes were placed for neurogenic bowel (72.1%,
n
= 155) and functional constipation (27.9%,
n
= 60). Technical success was 98.1% (211/215) and did not differ between centers (
p
= 0.74). Surgical repair was required for bowel leakage in 5.1% (11/215) and VP shunt infection was managed in 2.1% (2/95). Compared to functional constipation, patients with neurogenic bowel had higher % tube remaining (65.3% [96/147] versus 25.9% [15/58],
p
< 0.001) and higher ongoing flushes at follow-up (42.2% [62/147] versus 12.1% [7/58],
p
< 0.001). Tube removal for dissatisfaction occurred in 15.6% [32/205] and did not differ between groups (
p
= 0.98). Eight deaths due to co-morbidity occurred after a median of 7.4 years (IQR 9.3) of tube access.
Conclusion
Percutaneous cecostomy is technically successful in the vast majority of patients and provided durable access in most. Bowel leakage and VP shunt infection are uncommon, severe adverse events.
Graphical abstract</description><identifier>ISSN: 1432-1998</identifier><identifier>ISSN: 0301-0449</identifier><identifier>EISSN: 1432-1998</identifier><identifier>DOI: 10.1007/s00247-024-05936-2</identifier><identifier>PMID: 38693250</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Adverse events ; Cecostomy - methods ; Child ; Child, Preschool ; Constipation ; Fatalities ; Female ; Hospitals ; Humans ; Imaging ; Infant ; Infections ; Intestine ; Leakage ; Male ; Medicine ; Medicine & Public Health ; Morbidity ; Neuroradiology ; Nuclear Medicine ; Oncology ; Original Article ; Patients ; Pediatrics ; Postoperative Complications ; Radiology ; Retrospective Studies ; Shunts ; Success ; Treatment Outcome ; Tubes ; Ultrasound</subject><ispartof>Pediatric radiology, 2024-06, Vol.54 (7), p.1137-1143</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c326t-3e067b7d8eb2822aa4f0e764902bab8b31909ea2dfb7065b0ed3c4341b55f33b3</cites><orcidid>0000-0001-5818-4808</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38693250$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>James, Charles A.</creatorcontrib><creatorcontrib>Hogan, Mark J.</creatorcontrib><creatorcontrib>Seay, Ryan P.</creatorcontrib><creatorcontrib>James, Luke T.</creatorcontrib><creatorcontrib>Jensen, Hanna K.</creatorcontrib><creatorcontrib>Kaukis, Nicholas A.</creatorcontrib><creatorcontrib>Moore, Mary B.</creatorcontrib><creatorcontrib>Braswell, Leah E.</creatorcontrib><title>Percutaneous cecostomy: 25-year two institution experience</title><title>Pediatric radiology</title><addtitle>Pediatr Radiol</addtitle><addtitle>Pediatr Radiol</addtitle><description>Background
Reports of technical success, adverse events, and long-term outcome of percutaneous cecostomy in children are limited.
Objective
To characterize technical success, 30-day severe adverse events, and long-term outcome of percutaneous cecostomy at two centers.
Materials and methods
A retrospective review of hospital course and long-term follow-up (through May 2022) of percutaneous cecostomy tubes placed May 1997 to August 2011 at two children’s hospitals was used. Outcomes assessed included technical success (defined as successful tube placement into the colon allowing antegrade colonic enemas), length of stay, 30-day severe adverse events, surgery consults, surgical repair, VP shunt infection, ongoing flushes, tube removal, duration between maintenance tube exchanges, and deaths.
Results
A total of 215 procedures were performed in 208 patients (90 institution A, 125 institution B). Tubes were placed for neurogenic bowel (72.1%,
n
= 155) and functional constipation (27.9%,
n
= 60). Technical success was 98.1% (211/215) and did not differ between centers (
p
= 0.74). Surgical repair was required for bowel leakage in 5.1% (11/215) and VP shunt infection was managed in 2.1% (2/95). Compared to functional constipation, patients with neurogenic bowel had higher % tube remaining (65.3% [96/147] versus 25.9% [15/58],
p
< 0.001) and higher ongoing flushes at follow-up (42.2% [62/147] versus 12.1% [7/58],
p
< 0.001). Tube removal for dissatisfaction occurred in 15.6% [32/205] and did not differ between groups (
p
= 0.98). Eight deaths due to co-morbidity occurred after a median of 7.4 years (IQR 9.3) of tube access.
Conclusion
Percutaneous cecostomy is technically successful in the vast majority of patients and provided durable access in most. Bowel leakage and VP shunt infection are uncommon, severe adverse events.
Graphical abstract</description><subject>Adolescent</subject><subject>Adverse events</subject><subject>Cecostomy - methods</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Constipation</subject><subject>Fatalities</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Imaging</subject><subject>Infant</subject><subject>Infections</subject><subject>Intestine</subject><subject>Leakage</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Morbidity</subject><subject>Neuroradiology</subject><subject>Nuclear Medicine</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Postoperative Complications</subject><subject>Radiology</subject><subject>Retrospective Studies</subject><subject>Shunts</subject><subject>Success</subject><subject>Treatment Outcome</subject><subject>Tubes</subject><subject>Ultrasound</subject><issn>1432-1998</issn><issn>0301-0449</issn><issn>1432-1998</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp9kE1PwzAMhiMEYmPwBzigSly4FJy4aZvd0MSXhAQHOEdN66JOWzuSVLB_T0bHhzhwsS358etXL2PHHM45QHbhAESSxaHEIBWmsdhhY56giLlS-e6vecQOnJsDAEqO-2yEeapQSBiz6SPZsvdFS13vopLKzvluuZ5GQsZrKmzk37qoaZ1vfO-bro3ofUW2obakQ7ZXFwtHR9s-Yc_XV0-z2_j-4eZudnkflyhSHyNBmpmsysmIXIiiSGqgLE0UCFOY3CBXoKgQVW0ySKUBqrBMMOFGyhrR4ISdDbor27325LxeNq6kxWIwrREk8CzlAgN6-gedd71tg7tApblSqLINJQaqtJ1zlmq9ss2ysGvNQW-S1UOyOhT9mawW4ehkK92bJVXfJ19RBgAHwIVV-0L25_c_sh_IdIJ2</recordid><startdate>20240601</startdate><enddate>20240601</enddate><creator>James, Charles A.</creator><creator>Hogan, Mark J.</creator><creator>Seay, Ryan P.</creator><creator>James, Luke T.</creator><creator>Jensen, Hanna K.</creator><creator>Kaukis, Nicholas A.</creator><creator>Moore, Mary B.</creator><creator>Braswell, Leah E.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5818-4808</orcidid></search><sort><creationdate>20240601</creationdate><title>Percutaneous cecostomy: 25-year two institution experience</title><author>James, Charles A. ; Hogan, Mark J. ; Seay, Ryan P. ; James, Luke T. ; Jensen, Hanna K. ; Kaukis, Nicholas A. ; Moore, Mary B. ; Braswell, Leah E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c326t-3e067b7d8eb2822aa4f0e764902bab8b31909ea2dfb7065b0ed3c4341b55f33b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent</topic><topic>Adverse events</topic><topic>Cecostomy - methods</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Constipation</topic><topic>Fatalities</topic><topic>Female</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Imaging</topic><topic>Infant</topic><topic>Infections</topic><topic>Intestine</topic><topic>Leakage</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Morbidity</topic><topic>Neuroradiology</topic><topic>Nuclear Medicine</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Postoperative Complications</topic><topic>Radiology</topic><topic>Retrospective Studies</topic><topic>Shunts</topic><topic>Success</topic><topic>Treatment Outcome</topic><topic>Tubes</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>James, Charles A.</creatorcontrib><creatorcontrib>Hogan, Mark J.</creatorcontrib><creatorcontrib>Seay, Ryan P.</creatorcontrib><creatorcontrib>James, Luke T.</creatorcontrib><creatorcontrib>Jensen, Hanna K.</creatorcontrib><creatorcontrib>Kaukis, Nicholas A.</creatorcontrib><creatorcontrib>Moore, Mary B.</creatorcontrib><creatorcontrib>Braswell, Leah E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>James, Charles A.</au><au>Hogan, Mark J.</au><au>Seay, Ryan P.</au><au>James, Luke T.</au><au>Jensen, Hanna K.</au><au>Kaukis, Nicholas A.</au><au>Moore, Mary B.</au><au>Braswell, Leah E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Percutaneous cecostomy: 25-year two institution experience</atitle><jtitle>Pediatric radiology</jtitle><stitle>Pediatr Radiol</stitle><addtitle>Pediatr Radiol</addtitle><date>2024-06-01</date><risdate>2024</risdate><volume>54</volume><issue>7</issue><spage>1137</spage><epage>1143</epage><pages>1137-1143</pages><issn>1432-1998</issn><issn>0301-0449</issn><eissn>1432-1998</eissn><abstract>Background
Reports of technical success, adverse events, and long-term outcome of percutaneous cecostomy in children are limited.
Objective
To characterize technical success, 30-day severe adverse events, and long-term outcome of percutaneous cecostomy at two centers.
Materials and methods
A retrospective review of hospital course and long-term follow-up (through May 2022) of percutaneous cecostomy tubes placed May 1997 to August 2011 at two children’s hospitals was used. Outcomes assessed included technical success (defined as successful tube placement into the colon allowing antegrade colonic enemas), length of stay, 30-day severe adverse events, surgery consults, surgical repair, VP shunt infection, ongoing flushes, tube removal, duration between maintenance tube exchanges, and deaths.
Results
A total of 215 procedures were performed in 208 patients (90 institution A, 125 institution B). Tubes were placed for neurogenic bowel (72.1%,
n
= 155) and functional constipation (27.9%,
n
= 60). Technical success was 98.1% (211/215) and did not differ between centers (
p
= 0.74). Surgical repair was required for bowel leakage in 5.1% (11/215) and VP shunt infection was managed in 2.1% (2/95). Compared to functional constipation, patients with neurogenic bowel had higher % tube remaining (65.3% [96/147] versus 25.9% [15/58],
p
< 0.001) and higher ongoing flushes at follow-up (42.2% [62/147] versus 12.1% [7/58],
p
< 0.001). Tube removal for dissatisfaction occurred in 15.6% [32/205] and did not differ between groups (
p
= 0.98). Eight deaths due to co-morbidity occurred after a median of 7.4 years (IQR 9.3) of tube access.
Conclusion
Percutaneous cecostomy is technically successful in the vast majority of patients and provided durable access in most. Bowel leakage and VP shunt infection are uncommon, severe adverse events.
Graphical abstract</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>38693250</pmid><doi>10.1007/s00247-024-05936-2</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-5818-4808</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1432-1998 |
| ispartof | Pediatric radiology, 2024-06, Vol.54 (7), p.1137-1143 |
| issn | 1432-1998 0301-0449 1432-1998 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_3050176123 |
| source | Springer Nature |
| subjects | Adolescent Adverse events Cecostomy - methods Child Child, Preschool Constipation Fatalities Female Hospitals Humans Imaging Infant Infections Intestine Leakage Male Medicine Medicine & Public Health Morbidity Neuroradiology Nuclear Medicine Oncology Original Article Patients Pediatrics Postoperative Complications Radiology Retrospective Studies Shunts Success Treatment Outcome Tubes Ultrasound |
| title | Percutaneous cecostomy: 25-year two institution experience |
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