Antegrade continent enema procedures performed prior to starting school may improve functional stooling and quality of life.
Pediatr Surg Int
; 30(7): 715-22, 2014 Jul.
Article
en En
| MEDLINE
| ID: mdl-24874343
ABSTRACT
PURPOSE:
A major research gap is determining the best age to perform an appendicostomy or cecostomy. This study hypothesizes that performance of appendicostomy/cecostomy prior to starting school (<6 years) would improve functional stooling and quality of life (QOL).METHODS:
Patients who underwent appendicostomy/cecostomy for bowel management between 2003 and 2013 were retrospectively identified. Families were prospectively surveyed regarding current stooling habits (17 items) and a (7 item) pediatric QOL survey. Lower stooling survey scores represent better bowel control. Higher QOL scores indicated better quality. The primary outcome was to correlate age of appendicostomy/cecostomy to QOL score. Statistics were performed using paired, unpaired t tests, and Chi-square. p Values ≤0.05 were considered significant.RESULTS:
35 patients underwent placement of appendicostomy/cecostomy. Fourteen (40%) patients/families were prospectively contacted (<6, n = 6; >6, n = 8). Stooling scores (15.17 ± 1.35 vs. 22.25 ± 1.70; for <6 vs. >6 years old, p = 0.009) and continence scores (6.33 ± 1.45 vs. 11.13 ± 1.64; p = 0.06), at time of contacting families, were significantly better in those undergoing appendicostomy/cecostomy in the <6 group. Pre-procedure QOL scores for the two groups were similar (p = 0.89). Post-procedure QOL significantly increased to the good subcategory for both age groups; however improvement was significantly better in the <6 age group vs. ≥6 group 6.33 ± 0.92 vs. 3.13 ± 0.91 points (p = 0.03). A secondary parent survey showed significantly more families wished an appendicostomy/cecostomy were done earlier in the >6 vs. <6 group (87.5 vs. 33%; p = 0.04).CONCLUSION:
Early placement of cecostomy or appendicostomy as part of a bowel management program may contribute to improved QOL and functional stooling.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Calidad de Vida
/
Encuestas y Cuestionarios
/
Estreñimiento
/
Defecación
/
Enema
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Aspecto:
Patient_preference
Límite:
Child
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Pediatr Surg Int
Asunto de la revista:
PEDIATRIA
Año:
2014
Tipo del documento:
Article