Department of Pediatric Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, Canada, K1H 8L1; Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON, Canada, K1H 8M5.
Department of Pediatric Surgery, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, Canada, K1H 8L1.
J Pediatr Surg. 2020 Jul;55(7):1196-1200. doi: 10.1016/j.jpedsurg.2020.01.011. Epub 2020 Jan 25.
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.
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.
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.
Cecostomy has less post procedural complications, however rates of patient satisfaction and impact on quality of life were similar following both procedures.
III.
很少有研究直接比较经乙状结肠造口术和阑尾造口术在小儿粪便失禁管理中的作用。本系统综述描述了这两种手术的结果和并发症。我们还回顾了报告对生活质量和患者满意度影响的研究。
在 MEDLINE、EMBASE、Cochrane 中央对照试验注册中心（CENTRAL）和 Google Scholar 上搜索接受乙状结肠造口术或阑尾造口术的慢性便秘小儿患者的研究。两名评审员独立筛选研究、提取数据并评估质量。
初步文献检索检索到 633 条引文。在审查了所有摘要后，共有 40 项研究纳入最终分析，共评估了 2086 例患者。乙状结肠造口组的并发症总体发生率低于阑尾造口组（分别为 16.6%和 42.3%）。两组患者的粪便控便能力和生活质量改善情况相似，但阑尾造口组需要再次手术的比例约高 15%。
乙状结肠造口术后并发症较少，但两种手术的患者满意度和对生活质量的影响相似。
III 级。
