Current evidence on the safety and efficacy of percutaneous endoscopic colostomy (PEC) appears adequate to support the use of this procedure in elderly and frail patients with recurrent sigmoid volvulus and colonic motility problems provided that the normal arrangements are in place for audit and clinical governance.
Evidence on the use of PEC in children is limited. The care of children with chronic refractory constipation is complex and further evidence on the efficacy of the procedure and its place in the management of children would be useful. Patient selection in children is particularly important and should involve a multidisciplinary team that includes a paediatric gastroenterologist and colorectal surgeon. This procedure should be performed in specialist paediatric units.
Patients and/or their parents should be fully informed about the potential risk of peritonitis. They should be provided with clear written information. In addition, use of NICE's information for the public is recommended.