PubMed · 14952648
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
J M BEARDSLEY. 1952. Cecostomy.. https://doi.org/10.1016/0002-9610(52)90044-5
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
BACKGROUND: The role of surgeons as endoscopists has been extensively debated in the literature, with conflicting studies published regarding the safety and efficacy of surgeons performing colonoscopies. A multitude of medical federations and societies have set various standards for granting endoscopy privileges, many with a bias against general surgeons [1, 3]. We reviewed the colonoscopy experience at our institution to evaluate differences between gastroenterologists (GI) and general (GS) and colorectal surgeons (CRS) in procedure times and complication and cecal intubation rates. METHODS: Between January 2000 and July 2002, 5237 colonoscopies were performed at our institution. The data for procedure times, completion, and complication rates were collected in a prospective database. Complications were defined as perforation, bleeding, and postpolypectomy syndrome. Incomplete colonoscopies due to colitis, poor bowel preparation, or tumor obstruction were excluded. Chi-squared test was used to compare complication and cecal intubation rates between the three groups. Median procedure times were compared using the Kruskall-Wallis and Dunn's pairwise tests. A significant p-value was defined as <0.05. RESULTS: No differences in the complication rate was noted between the three groups: GI (0.12%), CRS (0.15%), and GS (0.11%) ( p = 0.99). There was a trend toward a lower incomplete colonoscopy rate in the GS group compared to CRS and GI: 0.32% vs 0.84% and 0.36%, respectively ( p = 0.07). The median colonoscopy times for GS (29 min), however, were shorter than for GI (34 min, p < 0.001) or CRS (31 min, p < 0.001). CONCLUSION: General surgeons perform colonoscopies expeditiously, with as low a morbidity rate and as high a completion rate as their gastroenterology or colorectal surgery colleagues. As the results of this study confirm, general surgeons should not be excluded from endoscopy suites.
Although the fundamental principles of interventional and minimally invasive image-guided techniques are the same in children as in adults, nonetheless the spectrum of diseases, the pediatric approach, and the devices used differ significantly from those in adults. The following is a general overview of image-guided gastrointestinal interventions in children and neonates, with emphasis on those aspects peculiar to children. Many of the facets and tips have been learned the hard way over the years, in a busy pediatric practice. Although there are several potential ways to do some of these procedures, the description below reflects our practice and experience. In general terms, minimizing radiation dose is a significant responsibility for the pediatric interventionalist. Reducing the number of exposures, reliance on last image hold, low-dose pulse fluoroscopy, and tight coning are all important. Protection for the radiologist is equally important, but sometimes difficult to achieve, given the small size of many of the patients.
The authors describe their experience with a series of 11 patients in whom they have carried out Chait cecostomy catheter insertion into a laparoscopically formed appendicostomy. This technique has several advantages compared with percutaneous insertion and we now insert the device at the primary procedure. The authors have had one minor complication in their 11 patients, with mean follow-up of 8 months. This technique is recommended for the management of refractory constipation, for etiologies including spina bifida, anorectal malformation, distal intestinal obstruction syndrome, and slow-colonic transit.