FECAL INCONTINENCE IN CHILDREN - TREATMENT WITH PERCUTANEOUS CECOSTOMY TUBE PLACEMENT - A PROSPECTIVE-STUDY

PURPOSE: To evaluate the technique used for and long-term results of p ercutaneous cecostomy tube placement for the treatment of fecal incont inence in children. MATERIALS AND METHODS: After an initial pilot stud y in 15 patients, 42 additional patients with fecal incontinence aged 2-20 (mean, 11.5) years and weighing 9.9-109.0 (mean, 39.2) kg underwe nt percutaneous cecostomy tube placement. Twenty-nine patients had spi na bifida, nine had imperforate anus, three had cloacal anomalies, and one had Hirschsprung disease. Mean follow-up was 265 days (range, 8-5 03 days). RESULTS: Tube placement was successful in all patients. One patient developed local inflammation after accidental early retention- suture removal, which was treated with suture replacement and intraven ous antibiotics. Another developed postprocedural ileus, which resolve d. Late complications included constipation in one patient (treated wi th diet alteration), granulation tissue in seven patients (treated wit h silver nitrate cautery), and accidentally dislodged tubes in three p atients (two successfully replaced at home and one replated at the rad iology suite). Vomiting related to the phosphate enema occurred in two patients. Resolution of soiling was achieved in all patients. CONCLUS ION: Percutaneous cecostomy and antegrade enemas are very successful i n achieving fecal continence and patient independence and acceptabilit y, with minimal early and late complications.