Efficacy of Enema via Cecostomy for Fecal Disorders in Children: A Systematic Review and Meta-Analysis

Authors

1 Liver and Digestive Research Center, Kurdistan University of Medical Sciences, Sanandaj, Iran.

2 Infectious and Tropical Diseases Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.

3 Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran.

4 Physiology Research Center, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Abstract

 
Background
 
Some controversy exists about the role of cecostomy in the management of fecal disorders. The present meta-analysis aims provide a comprehensive evaluation on the role of cecostomy on management of fecal incontinence and constipation in children.
 
Materials and Methods
 
An extensive search was performed on the Medline, Embase, Scopus, and Web of Science until July 2017. Two independent researchers screened the title and abstracts of the studies and then relevant studies were included. Finally, pooled effect size was presented as standardized mean difference (SMD) or pooled prevalence with 95% confidence interval (95% CI).
 
Results
 
14 articles were entered (740 children). The success rate of cecostomy in management of fecal disorders was 90.6% (success rate=90.6%; 95% CI: 86.4 to 94.2). The most common side effects of this technique include granulation tissue formation (29.6%), cecostomy tube leakage (8.5%), tube dislodgement (7.0%), and tube site infection (2.3%).
 
Conclusion
 
The results of the present meta-analysis show that the cecostomy is safe and an effective technique in the management of fecal disorder in children. However, the findings presented on the eligible articles have have shown a low level of evidence and it is suggested that clinical trials should be conducted in this field.
 

Keywords