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Fecal Incontinence: Cecostomy or appendicostomy?

Background: Few studies have directly compared between cecostomy and appendicostomy for the management of
fecal incontinence in pediatric population. This systematic review of the literature describes outcomes and complications following both procedures. We also reviewed studies reporting impact on quality of life and patient satisfaction.
Methods: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar were
searched for chronic constipation pediatric patients who underwent cecostomy or appendicostomy. Two reviewers
independently screened studies, extracted data, and assessed quality.
Results:An initial literature search retrieved 633 citations. After review of all abstracts, 40 studies were included in the
final analysis, assessing a total of 2086 patients. The overall rate of complications was lower in the cecostomy group
compared to the appendicostomy group (16.6% and 42.3%, respectively). Achievement of fecal continence and improvement in patient quality of life were found to be similar in both groups, however the need for revision of surgery
was approximately 15% higher in the appendicostomy group.
Conclusion: Cecostomy has less post procedural complications, however rates of patient satisfaction and impact on
quality of life were similar following both procedures.

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