Cecostomy tubes improve bowel continence for pediatric patients with spina bifida: A retrospective analysis of outcomes from a single clinic.
Asma A Taha, Aaron M Eisen, Hana Q Abdul Rahman and 7 others
PMID 38073339WHAT IT FOUND
Children with spina bifida who had cecostomy tubes reported bowel continence one step better on a five-point scale.
This means moving from daily to weekly accidents, or weekly to monthly. The tubes were used alongside other management strategies, so the exact contribution of the tube alone is unclear.
Key findings
01Patients with cecostomy placements had bowel continence scores 0.70 points higher on average compared to patients without placements.
02Within the group that received tubes, bowel continence scores were 0.83 points higher after placement compared to before.
03There were no significant differences in effectiveness among the different types of cecostomy placements (Chait, Malone, or other).
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was conducted at a single clinic, and the sample was primarily white and non-Hispanic, which limits generalizability. The measure of bowel continence was a single, unvalidated question and did not capture the severity or frequency of accidents within a day. Patients in the cecostomy group had more severe conditions and used more other bowel management strategies, so the effect of the tube alone cannot be separated from the other treatments. The number of patients with tubes was small relative to the total sample, and many had their tubes placed before the study began, limiting the ability to track change over time. The authors state that the evidence is not strong enough to inform clinical decisions on its own.
Declared interests
The paper states it was supported by the U.S. Public Health Service. No commercial conflicts of interest are reported in the text.
The easy way to misread this
Do not conclude that cecostomy tubes alone caused the improvement in bowel continence. The patients with tubes also used more other bowel management strategies, and the study could not separate the effect of the tube from these other treatments. Additionally, the authors note that the evidence is not yet strong enough to guide clinical decisions.