A single centre 20-year retrospective cohort study: Percutaneous endoscopic colostomy

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Interventional Endoscopy

Background:

• Percutaneous endoscopic colostomy (PEC) is an important intervention for specific patient groups.
• Limited data exist on the outcomes and complications associated with PEC.
• This study presents the largest recorded series of patients undergoing PEC.

Purpose of the Study:

• To analyze outcomes, complications, and survival rates in patients undergoing PEC.
• To compare results across different indications for PEC, including recurrent sigmoid volvulus (RSV), pseudo-obstruction, and neurogenic causes.
• To identify factors influencing patient outcomes after PEC.

Main Methods:

• Retrospective analysis of consultant logbooks from 1997 to 2020.
• Data collected included age, sex, indication, complications, mortality, and survival.
• Statistical analysis involved ANOVA, chi-squared, Fischer's exact tests, and Kaplan-Meier survival curves.

Main Results:

• Ninety-six PEC insertions were performed on 91 patients.
• The 30-day complication rate was 28%, with higher rates in RSV (23/72) and pseudo-obstruction (4/13) groups.
• 90-day mortality was 14.6% overall, significantly higher for RSV (18.5%) compared to pseudo-obstruction (7.7%) and neurogenic (data not specified but implied lower).

Conclusions:

• Patients with recurrent sigmoid volvulus and pseudo-obstruction undergoing PEC have poorer outcomes than neurogenic patients.
• Higher complication rates and shorter life expectancy are associated with RSV and pseudo-obstruction.
• High-volume specialist units should perform PEC, with careful patient selection and risk stratification.