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Surgical Endoscopy

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01-10-2011

Percutaneous endoscopic sigmoid colostomy for irrigation in the management of bowel dysfunction of adults with central neurologic disease

Authors: A. Ramwell, M. Rice-Oxley, A. Bond, J. N. L. Simson

Published in: Surgical Endoscopy | Issue 10/2011

Abstract

Background

Bowel dysfunction results in a major lifestyle disruption for many patients with severe central neurologic disease. Percutaneous endoscopic sigmoid colostomy for irrigation (PESCI) allows antegrade irrigation of the distal large bowel for the management of both incontinence and constipation. This study prospectively assessed the safety and efficacy of PESCI.

Methods

A PESCI tube was placed endoscopically in the sigmoid colon of 25 patients to allow antegrade irrigation.

Results

Control of constipation and fecal incontinence was improved for 21 (84%) of the 25 patients. These patients were followed up for 6–83 months (mean, 43 months), with long-term success for 19 (90%) of the patients. No PESCI had to be removed for technical reasons or for PESCI complications. Late removal of the PESCI was necessary for 2 of the 21 patients. A modified St. Marks Fecal Incontinence Score to assess bowel function before and after PESCI showed a highly significant improvement (P < 0.0001). There were no procedure-related deaths. Complications included minor sepsis at the initial PESCI tube site in four patients and bumper migration in two patients, but there were no complications related to the button device.

Conclusion

This study showed that PESCI is a simple, safe, and effective technique for distal antegrade irrigation in the management bowel dysfunction for selected patients with central neurologic disease. A successful PESCI is very likely to continue functioning satisfactorily for a long time without technical problems or local complications.

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Title: Percutaneous endoscopic sigmoid colostomy for irrigation in the management of bowel dysfunction of adults with central neurologic disease
Authors: A. Ramwell
M. Rice-Oxley
A. Bond
J. N. L. Simson
Publication date: 01-10-2011
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 10/2011
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-011-1701-6

At a glance: The STEP trials

Springer Medicine

Percutaneous endoscopic sigmoid colostomy for irrigation in the management of bowel dysfunction of adults with central neurologic disease

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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