A.H. Balcom, MD
C.T. Durkee, MD
H.O. Mesrobian, MD
- For the percutaneous cecostomy, your child is hospitalized for 1 to 3 days.
- For the surgically created cecostomy (ACE Procedure), your child is hospitalized for 5 to 7 days.
- Your child will have some discomfort with either type of procedure. Pain medicines will be used to keep your child as comfortable as possible.
- Your child should be able to eat and drink 4 hours of the percutaneous placement. However, it may be several days after an ACE procedure before you child can eat.
- The tube can be used for the antegrade enema procedure typically within a few days of its construction surgically. Your doctor or nurse will help your child with the first antegrade enema.
- Healing will take about 1 to 2 weeks after the percutaneous tube placement. Healing will take 2 to 4 weeks after the surgical tube placement.
- Your doctor or nurse will tell you how to care for the cecostomy site.
There are risks and complications for this procedure. The main ones are that it involves surgery on the intestines, and the intestines can leak and/or become obstructed postoperatively, or infection can develop. These are rare. The main problem that we have is that the opening of the appendix on the skin site can become narrow, requiring a redo operation; this is about 10 percent of the time. Some families find that if they leave a catheter in the stoma once a week, this keeps the stoma open and avoids the need for a revision. Very rarely, stool will leak backwards out of the appendix onto the skin. This is the kind of thing that may also necessitate a redo operation to correct.
With the percutaneous method...
- In children with VP shunts, infections may occur if stool leaks into the abdominal cavity.
- Infection of the skin around the stoma site.
- Infection of the lining of the inside of the abdomen.
With the surgical method...
- The tube might fall out or break.
- Scar tissue or granulation tissue may grow around the opening.
- If your child has a tube, the tube needs to be changed every few months. A parent or home nurse can do this. This is not usually uncomfortable for the child and often takes less than 5 minutes to do.
- The opening may start to close and need further surgery to open the hole.