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Updated: Jun 27, 2025
Cecal Ligation Puncture Procedure
Published on: May 7, 2011
Percutaneous cecostomy: 25-year two institution experience
Charles A James1, Mark J Hogan2, Ryan P Seay2
1Department of Radiology, Arkansas Children's Hospital, University of Arkansas for Medical Sciences, Slot 105, 1 Children's Way, Little Rock, 72202, AR, USA. JamesCharlesA@uams.edu.
Insights
Percutaneous cecostomy is a technically successful procedure for children, offering durable access for managing bowel issues. Severe adverse events like bowel leakage and VP shunt infection are rare, ensuring patient safety.
Area of Science:
- Pediatric surgery
- Gastroenterology
- Interventional radiology
Background:
- Limited data exists on the technical success, adverse events, and long-term outcomes of percutaneous cecostomy in pediatric patients.
- Percutaneous cecostomy is a minimally invasive procedure used for antegrade colonic enemas in children with complex bowel management needs.
Purpose of the Study:
- To evaluate the technical success rate of percutaneous cecostomy.
- To assess the incidence of severe adverse events within 30 days post-procedure.
- To characterize the long-term outcomes and complications associated with percutaneous cecostomy in children.
Main Methods:
- A retrospective review was conducted of 215 percutaneous cecostomy procedures performed in 208 pediatric patients across two institutions from May 1997 to August 2011.
- Outcomes included technical success, 30-day severe adverse events, surgical repair rates, shunt infections, ongoing flush requirements, tube removal, and mortality.
- Long-term follow-up extended through May 2022.
Main Results:
- Technical success was achieved in 98.1% of procedures, with no significant difference between the two centers.
- Severe adverse events were uncommon: 5.1% required surgical repair for bowel leakage and 2.1% experienced VP shunt infection.
- Patients with neurogenic bowel had a higher rate of long-term tube retention (65.3%) and ongoing flushes (42.2%) compared to those with functional constipation.
Conclusions:
- Percutaneous cecostomy demonstrates high technical success and provides durable access for pediatric patients requiring bowel management.
- The procedure is associated with a low incidence of severe adverse events, including bowel leakage and VP shunt infection.
- Long-term outcomes indicate the procedure's efficacy, particularly for neurogenic bowel management, though ongoing care is often necessary.
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.
