Outcomes and Complications of Chait Trapdoor Cecostomy in Pediatric Patients with Therapy-Resistant Constipation and Fecal Incontinence: A 14-Year Retrospective Study

Aim of the Study To assess the incidence and types of complications and patient-reported outcomes in pediatric patients with therapy-resistant constipation or fecal incontinence (FI) without constipation who underwent Chait Trapdoor^TM cecostomy (CTC). The findings contribute to the discussion on selecting the optimal antegrade continence (ACE) procedure for this population. Materials and Methods A retrospective review was conducted on all pediatric patients with therapy-resistant constipation or FI without constipation who underwent a CTC procedure at our tertiary referral center between 2009 and 2023. Postoperative complications were classified using the Clavien-Madadi classification. At their most recent follow-up in 2023, patients reported satisfaction with their CTC. Results The study included 62 children (median age 12 years [IQR 8–14; range 1–17], 42% male), with a median follow-up of 4 years (IQR 2–8, range 0–14). Underlying diagnoses were functional constipation (n ¼ 39, 63%), spina bifida (n ¼ 11, 18%), and anorectal malformations (n ¼ 5, 8%). A total of 49/62 patients (79%) experienced 89 CTC-related complications. Minor complications (Clavien-Madadi I–II) affected 29 patients (47%) and most commonly included granulation. Major complications (Clavien-Madadi III–IV) requiring surgery occurred in 32% of patients. Despite these complications, 40/62 (65%) patients reported satisfaction with their CTC, as determined by partial or complete symptom resolution.