Antegrade continent enema procedures performed prior to starting school may improve functional stooling and quality of life

被引:13
作者
Freeman, Jennifer J. [1 ]
Simha, Siddartha [1 ]
Jarboe, Marcus D. [1 ]
Ehrlich, Peter F. [1 ]
Teitelbaum, Daniel H. [1 ]
机构
[1] Univ Michigan Hlth Syst, Pediat Surg Sect, Dept Surg, CS Mott Childrens Hosp, Ann Arbor, MI 48109 USA
关键词
Appendicostomy; Cecostomy; Bowel management; Quality of life; Imperforate anus; HIGH IMPERFORATE ANUS; FECAL INCONTINENCE; ANORECTAL-MALFORMATIONS; CHILDREN; MANAGEMENT; REPAIR;
D O I
10.1007/s00383-014-3520-z
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
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). 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 a parts per thousand currency sign0.05 were considered significant. 35 patients underwent placement of appendicostomy/cecostomy. Fourteen (40 %) patients/families were prospectively contacted (< 6, n = 6; > 6, n = 8). Stooling scores (15.17 +/- A 1.35 vs. 22.25 +/- A 1.70; for < 6 vs. > 6 years old, p = 0.009) and continence scores (6.33 +/- A 1.45 vs. 11.13 +/- A 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. a parts per thousand yen6 group: 6.33 +/- A 0.92 vs. 3.13 +/- A 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). Early placement of cecostomy or appendicostomy as part of a bowel management program may contribute to improved QOL and functional stooling.
引用
收藏
页码:715 / 722
页数:8
相关论文
共 17 条
  • [1] Quality of life for children with fecal incontinence after surgically corrected anorectal malformation
    Bai, YZ
    Yuan, ZW
    Wang, WL
    Zhao, YR
    Wang, HZ
    Wang, W
    [J]. JOURNAL OF PEDIATRIC SURGERY, 2000, 35 (03) : 462 - 464
  • [2] Tap water irrigation and additives to optimize success with the malone antegrade continence enema: The Indiana university algorithm
    Bani-Hani, Ahmad H.
    Cain, Mark P.
    King, Shelly
    Rink, Richard C.
    [J]. JOURNAL OF UROLOGY, 2008, 180 (04) : 1757 - 1760
  • [3] Neoappendicostomy in the management of pediatric fecal incontinence
    Chatoorgoon, Kaveer
    Pena, Alberto
    Lawal, Taiwo
    Hamrick, Miller
    Louden, Emily
    Levitt, Marc A.
    [J]. JOURNAL OF PEDIATRIC SURGERY, 2011, 46 (06) : 1243 - 1249
  • [4] SHORT-TERM V LONG-TERM QUALITY-OF-LIFE IN CHILDREN FOLLOWING REPAIR OF HIGH IMPERFORATE ANUS
    DITESHEIM, JA
    TEMPLETON, JM
    [J]. JOURNAL OF PEDIATRIC SURGERY, 1987, 22 (07) : 581 - 587
  • [5] Are the long-term results of the transanal pull-through equal to those of the transabdominal pull-through? A comparison of the 2 approaches for Hirschsprung disease
    El-Sawaf, Mohamed I.
    Drongowski, Robert A.
    Chamberlain, Jennifer N.
    Coran, Arnold G.
    Teitelbaum, Daniel H.
    [J]. JOURNAL OF PEDIATRIC SURGERY, 2007, 42 (01) : 41 - 47
  • [6] Quality of life in pediatric patients with unremitting constipation pre and post Malone Antegrade Continence Enema (MACE) procedure
    Har, Aileen F.
    Rescorla, Frederick J.
    Croffie, Joseph M.
    [J]. JOURNAL OF PEDIATRIC SURGERY, 2013, 48 (08) : 1733 - 1737
  • [7] Long-term functional outcome and quality of life in patients with high imperforate anus
    Hashish, Mohamed S.
    Dawoud, Hamada H.
    Hirschl, Ronald B.
    Bruch, Steven W.
    El Batarny, Akram M.
    Mychaliska, George B.
    Drongowski, Robert A.
    Ehrlich, Peter F.
    Hassaballa, Sayed Z.
    El-Dosuky, Nagi I.
    Teitelbaum, Daniel H.
    [J]. JOURNAL OF PEDIATRIC SURGERY, 2010, 45 (01) : 224 - 230
  • [8] Continent appendicostomy in the bowel management of fecally incontinent children
    Levitt, MA
    Soffer, SZ
    Pena, A
    [J]. JOURNAL OF PEDIATRIC SURGERY, 1997, 32 (11) : 1630 - 1633
  • [9] Levitt MA, 2005, OSTOMY Q, V42, P44
  • [10] PSYCHOSOCIAL ADJUSTMENT OF CHILDREN TREATED FOR ANORECTAL ANOMALIES
    LUDMAN, L
    SPITZ, L
    [J]. JOURNAL OF PEDIATRIC SURGERY, 1995, 30 (03) : 495 - 499