Ileal Neoappendicostomy in the Treatment of Fecal Incontinence in Children
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In brief
In brief
Retrospective study of 10 children who underwent ileal neoappendicostomy for antegrade colonic enema when the appendix was unavailable. Despite minor complications and stomal issues, patients reported high satisfaction and achieved continence at 57-month follow-up, supporting this as a viable alternative for severe constipation and fecal incontinence.
Written by the GCMD Library team from the article.
Introduction An antegrade colonic enema (ACE) via an appendicostomy has been shown to be effective in the management of functional bowel problems. In cases with a missing appendix, a neoappendicostomy may be considered.
Materials and Methods A retrospective review of clinical outcomes in children who underwent ileal neoappendicostomy for ACE. Medical records were reviewed for data on demography, intra- and postoperative complications. A follow-up questionnaire on stoma problems, ACE-related problems, bowel function, patient satisfaction, well-being, and effect on daily activities was performed.
Results Ten patients were included at an average age of 10.6 years at surgery. In half of the patients, minor postoperative complications (Clavien–Dindo grade 2 or less) were found. Nine patients answered the questionnaire with a mean follow-up of 57 months. Despite complaints of stomal leakage, difficulties with catheterization, and pain during irrigation, they reported a high grade of satisfaction, improvements in well-being, and bowel function and the achievement of continence.
Conclusion Ileal neoappendicostomy may be an alternative to ACE in children with severe and medically intractable constipation and or/and fecal incontinence where the appendix is missing or not available.