The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Keith E Georgeson - One of the best experts on this subject based on the ideXlab platform.
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laparoscopic Cecostomy button placement for the management of fecal incontinence in children with hirschsprung s disease and anorectal anomalies
Surgical Endoscopy and Other Interventional Techniques, 2006Co-Authors: A Yagmurlu, Carroll M Harmon, Keith E GeorgesonAbstract:Background Antegrade colonic enemas offer a surgical solution for many children with chronic constipation and encopresis associated with Hirschsprung’s disease and anorectal malformations. This study demonstrated the feasibility of a new laparoscopic technique for Cecostomy button placement (LCBP) to allow antegrade enema treatment.
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laparoscopic Cecostomy button placement for the management of fecal incontinence in children with hirschsprung s disease and anorectal anomalies
Surgical Endoscopy and Other Interventional Techniques, 2006Co-Authors: A Yagmurlu, Carroll M Harmon, Keith E GeorgesonAbstract:Antegrade colonic enemas offer a surgical solution for many children with chronic constipation and encopresis associated with Hirschsprung’s disease and anorectal malformations. This study demonstrated the feasibility of a new laparoscopic technique for Cecostomy button placement (LCBP) to allow antegrade enema treatment. Charts of children with encopresis who underwent LCBP between 1999 and 2001 were reviewed. The age, weight, primary diagnosis, operative time, hospital stay, associated complications, follow-up duration, and outcome of the patients were recorded. The surgical technique used a “U-stitch” method and a chait tube or a standard gastrostomy button. A follow-up telephone survey was conducted to assess parental satisfaction and overall success in continence. Seven patients ages 4 to 12 years (mean, 7.3 ± 1.3 years) and weighing 15 to 44 kg (mean, 24.5 ± 4 kg) underwent LCBP over a 2-year period. The mean follow-up period was 15 ± 4 months (range, 6–33 months). Four patients had anorectal malformations, and three patients had Hirschsprung’s disease. For all the patients, LCBP was accomplished without any intraoperative complications. The mean operative time was 33 ± 2 min, and the hospital stay was 2 to 5 days (mean, 3.8 ± 0.5 days). The patients received one or two daily antegrade enemas, and none had accidental bowel movements. Episodes of soiling at night once or twice a week were observed with two children. Two patients had hypertrophic granulation tissue formation, which responded to topical therapy. The button was uneventfully changed twice in one patient because of mechanical malfunction. To manage overflow incontinence of children with anorectal malformations and Hirschsprung’s disease, LCBP is a technically straightforward, effective, and reversible method for the placement of a Cecostomy button.
Todd H Baron - One of the best experts on this subject based on the ideXlab platform.
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palliative use of percutaneous endoscopic gastrostomy and percutaneous endoscopic Cecostomy tubes
Gastrointestinal Endoscopy Clinics of North America, 2007Co-Authors: Adrian N Holm, Todd H BaronAbstract:Percutaneous endoscopic gastrostomy (PEG) tubes are most commonly placed for feeding purposes with the intention of maintenance or improvement in nutritional status; however, they may also be used in a palliative role in patients who have terminal illnesses for feeding or decompression. Percutaneous endoscopic Cecostomy (PEC) tubes can be used to decompress malignant and functional bowel disorders with accepted morbidity and mortality. This article reviews the use of PEG and PEC tubes for palliative use.
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percutaneous endoscopic Cecostomy a case series
Gastrointestinal Endoscopy, 2003Co-Authors: Jack I Ramage, Todd H BaronAbstract:Background: There are few reports of percutaneous endoscopic Cecostomy in adult patients. Methods: All cases of acute colonic pseudo-obstruction (n = 2) and neurogenic bowel (n = 3) in adults in which percutaneous endoscopic Cecostomy was performed were reviewed retrospectively. Observations: Percutaneous endoscopic Cecostomy was a definitive treatment. In 1 of the 2 patients with acute colonic pseudo-obstruction, the percutaneous endoscopic Cecostomy tube was clamped and subsequently removed 10 weeks after placement; in the other patient with acute colonic pseudo-obstruction, the percutaneous endoscopic Cecostomy tube remains in place. In 2 of the 3 patients with neurogenic bowel, the percutaneous endoscopic Cecostomy tube continues to function well; the third patient did well for 6 months and then died of underlying comorbid disease. There was no mortality or need for surgical intervention for any patient. Complications occurred in 2 patients; 1 developed transient fever and leukocytosis and 1 had self-limited bleeding during anticoagulation. Conclusions: Percutaneous endoscopic Cecostomy is a safe and effective treatment for both acute colonic pseudo-obstruction and neurogenic bowel when aggressive albeit conservative treatment is unsuccessful.
A Yagmurlu - One of the best experts on this subject based on the ideXlab platform.
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laparoscopic Cecostomy button placement for the management of fecal incontinence in children with hirschsprung s disease and anorectal anomalies
Surgical Endoscopy and Other Interventional Techniques, 2006Co-Authors: A Yagmurlu, Carroll M Harmon, Keith E GeorgesonAbstract:Background Antegrade colonic enemas offer a surgical solution for many children with chronic constipation and encopresis associated with Hirschsprung’s disease and anorectal malformations. This study demonstrated the feasibility of a new laparoscopic technique for Cecostomy button placement (LCBP) to allow antegrade enema treatment.
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laparoscopic Cecostomy button placement for the management of fecal incontinence in children with hirschsprung s disease and anorectal anomalies
Surgical Endoscopy and Other Interventional Techniques, 2006Co-Authors: A Yagmurlu, Carroll M Harmon, Keith E GeorgesonAbstract:Antegrade colonic enemas offer a surgical solution for many children with chronic constipation and encopresis associated with Hirschsprung’s disease and anorectal malformations. This study demonstrated the feasibility of a new laparoscopic technique for Cecostomy button placement (LCBP) to allow antegrade enema treatment. Charts of children with encopresis who underwent LCBP between 1999 and 2001 were reviewed. The age, weight, primary diagnosis, operative time, hospital stay, associated complications, follow-up duration, and outcome of the patients were recorded. The surgical technique used a “U-stitch” method and a chait tube or a standard gastrostomy button. A follow-up telephone survey was conducted to assess parental satisfaction and overall success in continence. Seven patients ages 4 to 12 years (mean, 7.3 ± 1.3 years) and weighing 15 to 44 kg (mean, 24.5 ± 4 kg) underwent LCBP over a 2-year period. The mean follow-up period was 15 ± 4 months (range, 6–33 months). Four patients had anorectal malformations, and three patients had Hirschsprung’s disease. For all the patients, LCBP was accomplished without any intraoperative complications. The mean operative time was 33 ± 2 min, and the hospital stay was 2 to 5 days (mean, 3.8 ± 0.5 days). The patients received one or two daily antegrade enemas, and none had accidental bowel movements. Episodes of soiling at night once or twice a week were observed with two children. Two patients had hypertrophic granulation tissue formation, which responded to topical therapy. The button was uneventfully changed twice in one patient because of mechanical malfunction. To manage overflow incontinence of children with anorectal malformations and Hirschsprung’s disease, LCBP is a technically straightforward, effective, and reversible method for the placement of a Cecostomy button.
Peter Chait - One of the best experts on this subject based on the ideXlab platform.
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the percutaneous Cecostomy tube in the management of fecal incontinence in children
Journal of Vascular and Interventional Radiology, 2015Co-Authors: Waqas Ullah Khan, Janakan Satkunasingham, Rahim Moineddin, Irfan Jamal, Samia Afzal, Peter Chait, Dimitri A Parra, Joao G Amaral, Michael TempleAbstract:Abstract Purpose To retrospectively evaluate experience with percutaneous cecostomies and their long-term outcomes. Materials and Methods Between June 1994 and March 2009, 290 patients (mean age, 10.1 y) with fecal incontinence underwent percutaneous Cecostomy tube placement and subsequent tube management. Technical success, procedural complications, and long-term follow-up until March 2012 were evaluated. Results A Cecostomy was successfully placed in 284 patients (98%), and 257 of 280 patients (92%) underwent a successful exchange to a low-profile tube. A total of 1,431 routine exchanges to low-profile tubes were reviewed in 258 patients (mean, 1.6 ± 1.3 routine tube changes per 1,000 days). Eighty-five patients (29%) experienced one or more early problems after Cecostomy, and 10 (3%) had major complications. In the total 463,507 tube-days, 938 late problems were noted: 917 (98%) minor and 22 (2%) major. Forty patients had the Cecostomy catheter removed and 141 "graduated" to an adult health care facility. Conclusions The percutaneous Cecostomy procedure provides a safe management option for fecal incontinence in the pediatric population.
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percutaneous Cecostomy updates in technique and patient care
Radiology, 2003Co-Authors: Peter Chait, Joao G Amaral, Michael Temple, Helen Forrest Richards, Bairbre Connolly, Eran Shlomovitz, Ricardo Restrepo, Sergio Muraca, Sigmund H EinAbstract:PURPOSE: To evaluate the authors’ 7-year experience with the percutaneous Cecostomy procedure and the long-term outcome of the procedure. MATERIALS AND METHODS: Since 1994, 163 tube cecostomies for fecal incontinence were performed in patients aged 2–23 years and who weighed 8–72 kg (mean, 32.2 kg). Underlying conditions included spina bifida (n = 106), imperforate anus (n = 53), Klippel-Feil deformity (n = 1), cerebral palsy (n = 1), Hirschsprung disease (n = 1), and paraplegia (n = 1). Ventriculoperitoneal shunts were present in 85 (52%) of the 163 patients. The authors have followed up 124 (76%) of the 163 Cecostomy patients. Information regarding enema technique, satisfaction with the procedure, postprocedure problems, and long-term outcome of the procedure was obtained by interviewing either the patients or the parents. RESULTS: Tube placement was successful in all patients. One hundred ten (89%) of the 124 patients experienced a substantial decrease in the frequency of soiling accidents. The vast ma...
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the Cecostomy button
Journal of Pediatric Surgery, 1997Co-Authors: Peter Chait, Barry Shandling, Helen Forrest RichardsAbstract:Percutaneous insertion of a Cecostomy tube, performed under local anesthesia, to facilitate antegrade colonic cleansing, has been an invaluable advance in the management of fecal incontinence. However, the patient is left with a length of tubing (2 to 4 inches) protruding from the Cecostomy site that has to be taped down to the abdominal wall. Available devices for insertion in place of the Cecostomy tube are cumbersome and have a relatively high profile, projecting more than 1 cm from the surface of the abdominal wall. Worn under a swimsuit, they are clearly discernible. The inflated balloon within the cecum can occasionally break. Furthermore, in the individual with a relatively thick abdominal wall, such devices are too short to reach from the skin to the cecum. A new form of low-profile trapdoor device has been developed that overcomes the above shortcomings of other available "buttons." It has been successfully used in a clinical setting in 49 patients.
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fecal incontinence in children treatment with percutaneous Cecostomy tube placement a prospective study
Radiology, 1997Co-Authors: Peter Chait, B Shandling, H M Richards, Bairbre ConnollyAbstract:PURPOSE: To evaluate the technique used for and long-term results of percutaneous Cecostomy tube placement for the treatment of fecal incontinence in children. MATERIALS AND METHODS: After an initial pilot study in 15 patients, 42 additional patients with fecal incontinence aged 2-20 (mean, 11.5) years and weighing 9.9-109.0 (mean, 39.2) kg underwent percutaneous Cecostomy tube placement. Twenty-nine patients had spina bifida, nine had imperforate anus, three had cloacal anomalies, and one had Hirschsprung disease. Mean follow-up was 265 days (range, 8-503 days). RESULTS: Tube placement was successful in all patients. One patient developed local inflammation after accidental early retention-suture removal, which was treated with suture replacement and intravenous antibiotics. Another developed postprocedural ileus, which resolved. Late complications included constipation in one patient (treated with diet alteration), granulation tissue in seven patients (treated with silver nitrate cautery), and accidentally dislodged tubes in three patients (two successfully replaced at home and one replaced at the radiology suite). Vomiting related to the phosphate enema occurred in two patients. Resolution of soiling was achieved in all patients. CONCLUSION: Percutaneous Cecostomy and antegrade enemas are very successful in achieving fecal continence and patient independence and acceptability, with minimal early and late complications.
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percutaneous Cecostomy a new technique in the management of fecal incontinence
Journal of Pediatric Surgery, 1996Co-Authors: Barry Shandling, Peter Chait, Helen Forrest RichardsAbstract:A pilot study on the percutaneous introduction of a Cecostomy tube for colonic irrigations in the treatment of children with fecal incontinence is described. The results were good, and the technique is recommended for certain patients.
Hayat Mousa - One of the best experts on this subject based on the ideXlab platform.
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colonic manometry as predictor of Cecostomy success in children with defecation disorders
Journal of Pediatric Surgery, 2006Co-Authors: Maartje M Van Den Berg, Donna A Caniano, Mark J Hogan, Carlo Di Lorenzo, Marc A Benninga, Hayat MousaAbstract:Abstract Purpose The aim of this study was to define the predictive value of colonic manometry and contrast enema before Cecostomy placement in children with defecation disorders. Methods Medical records, contrast enema, and colonic manometry studies were reviewed for 32 children with defecation disorders who underwent Cecostomy placement between 1999 and 2004. Diagnoses included idiopathic constipation (n = 13), Hirschsprung's disease (n = 2), cerebral palsy (n = 1), imperforate anus (n = 6), spinal abnormality (n = 6), and anal with spinal abnormality (n = 4). Contrast enemas were evaluated for the presence of anatomic abnormalities and the degree of colonic dilatation. Colonic manometry was considered normal when high-amplitude propagating contractions (HAPC) occurred from proximal to distal colon. Clinical success was defined as normal defecation frequency with no or occasional fecal incontinence. Results Colonic manometry was done on 32 and contrast enema on 24 patients before Cecostomy. At follow-up, 25 patients (78%) fulfilled the success criteria. Absence of HAPC throughout the colon was related to unsuccessful outcome ( P = .03). Colonic response with normal HAPC after bisacodyl administration was predictive of success ( P = .03). Presence of colonic dilatation was not associated with colonic dysmotility. Conclusion Colonic manometry is helpful in predicting the outcome after Cecostomy. Patients with generalized colonic dysmotility are less likely to benefit from use of antegrade enemas via Cecostomy. Normal colonic response to bisacodyl predicts favorable outcome.
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Cecostomy in children with defecation disorders
Digestive Diseases and Sciences, 2006Co-Authors: Hayat Mousa, Maartje M Van Den Berg, Donna A Caniano, Mark J Hogan, Carlo Di Lorenzo, John R HayesAbstract:Administration of antegrade enemas through a Cecostomy is a therapeutic option for children with severe defecation disorders. The purpose of this study is to report our 4-year experience with the Cecostomy procedure in 31 children with functional constipation (n = 9), Hirschsprung's disease (n = 2), imperforate anus (n = 5), spinal abnormalities (n = 8), and imperforate anus in combination with tethered spinal cord (n = 7). Data regarding complications, antegrade enemas used, symptoms, and quality of life were retrospectively obtained. Placement of Cecostomy tubes was successful in 30 of 31 patients. Soiling episodes decreased significantly in children with functional constipation (P = 0.01), imperforate anus (P < 0.01), and spinal abnormalities (P = 0.04). Quality of life improved in patients with functional constipation and imperforate anus. No difference in complications was found between percutaneous and surgical placement. Use of antegrade enemas via Cecostomy improved symptoms and quality of life in children with a variety of defecation disorders.