Outcomes after appendicostomy and neo-appendicostomy in a single institution

Area of Science:

• Surgical interventions for pediatric bowel management.
• Gastroenterology and Colorectal Surgery.

Background:

• Established bowel management programs often utilize retrograde enemas.
• Transitioning to antegrade enema administration may improve outcomes.
• Appendicostomy and neo-appendicostomy create channels for efficient enema delivery.

Purpose of the Study:

• To evaluate the long-term outcomes of appendicostomy and neo-appendicostomy.
• To assess indications for semi-permanent devices.
• To identify and analyze post-operative complications.

Main Methods:

• Retrospective analysis of patients undergoing appendicostomy or neo-appendicostomy.
• Review of underlying diagnoses, long-term channel use, device indications, and complications.
• Multivariate analysis to identify predictors of post-operative complications.

Main Results:

• 230 patients with diagnoses including anorectal malformation, neurogenic bowel, Hirschsprung's disease, and idiopathic constipation.
• Over 95% of patients maintained successful long-term antegrade enema use.
• Common complications included stricture (26%), wound infection (17.4%), and stool leakage (13%).

Conclusions:

• Appendicostomy and neo-appendicostomy demonstrate high rates of successful long-term channel use for antegrade enemas.
• Counseling patients/families on potential complications and the need for reoperation or semi-permanent devices is crucial.
• A minority of patients may require intervention for complications such as leakage or stricture.