Temporary Disabled. :) please Go back Percutaneous endoscopic colostomy www.fgks.org » Address: [go: up one dir, main page] Include Form Remove Scripts Accept Cookies Show Images Show Referer Rotate13 Base64 Strip Meta Strip Title Session Cookies Sign In | Register Home News Get involved About NICE Find guidance NICE Pathways Quality standards Into practice QOF Conditions and diseases Blood and immune system • Cancer • Cardiovascular • Central nervous system • Digestive system • Ear and nose • Endocrine, nutritional and metabolic • Eye • Gynaecology, pregnancy and birth • Infectious diseases • Injuries, accidents and wounds • Mental health and behavioural conditions • Mouth and dental • Musculoskeletal • Respiratory • Skin • Urogenital Public health Accidents and injuries • Alcohol • Behaviour change • Cancer • Cardiovascular disease • Child health • Child social care • Chronic illness • Diabetes • Drugs • Environmental health • Infectious diseases • Maternal health • Mental health • Non-communicable diseases • Obesity and diet • Occupational health • Older people • Physical activity • Sexual health • Smoking and tobacco • Transport • Vaccine preventable diseases • Working with and involving communities Treatments, Procedures and Devices Bones and joint surgery • Cardiovascular surgery • Cardiovascular system drug treatments • Clinical devices • Diagnostic imaging • Diagnostic procedures • Digestive tract and other abdominal organs surgery • Drug treatments • Endocrine system and breast surgery • Eye surgery • Nervous system surgery • Radiotherapy • Screening • Surgical procedures • Therapeutic procedures • Tissue and organ donation • Urogenital surgery Guidance by type Clinical Guidelines • Technology appraisals • Public health guidance • Diagnostics guidance • Interventional procedures guidance • Medical technologies guidance • Cancer service guidance • Quality standards Guidance by date View the guidance by date published About NICE guidance Close Home>About NICE guidance>Guidance by type>Interventional procedures>Percutaneous endoscopic colostomy IPG161 Percutaneous endoscopic colostomy (IPG161) Interventional procedures IPG161 Issued: March 2006 Percutaneous endoscopic colostomy The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on percutaneous endoscopic colostomy. Description Percutaneous endoscopic sigmoid colostomy (PEC) is a variation of the percutaneous endoscopic gastrostomy technique which has been well established for enteral gastric feeding since 1980. A colonoscope is inserted into the left colon per rectum until transillumination is seen through the skin surface and finger pressure indents the colon. The PEG tube kit is passed through the scope with the snare. Under local anaesthesia, a small incision is made in the skin and a hollow needle is passed through the abdominal wall into the bowel. The snare passes over the visualised needle to grasp it and is then withdrawn with the wire and colonoscope through the anal canal. A 20F catheter system is securely tied with wire and pulled retrogradely through the bowel and abdominal wall and is then secured against the abdominal wall. To check the final position of the catheter, the colonoscope is reinserted. The catheter is then attached to a drainage bag, flushed twice a day and antibiotics are administered for five days postoperatively. This tube can be in situ for the long term or short term, depending on indications for use. PEC can be used: to treat recurrent sigmoid volvulus acute colonic pseudo-obstruction faecal constipation faecal incontinence for the delivery of anti-inflammatory agents for patients with colitis PEC offers an alternative treatment for patients who have tried conventional treatment options without success. Various surgical techniques as an alternative to PEC include sigmoidopexy, sigmoidoplasty, trephine stoma to resection with primary anastomosis. Traditional treatment options for sigmoid volvulus comprise endoscopic decompression and/or open resection. However, these treatment options have varying success with endoscopic decompression having a recurrence rate of approximately 40% and open resection may be contraindicated for frail, elderly patients or the severely immunocompromised. OPCS4.6 Code(s) H15.7 Percutaneous endoscopic sigmoid colostomy The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS. The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided. www.connectingforhealth.co.uk/clinicalcoding Other information IPG161 Percutaneous endoscopic colostomy - guidance (web format) IPG161 Percutaneous endoscopic colostomy - guidance IPG161 Percutaneous endoscopic colostomy - information for the public Interventional procedure consultation document - percutaneous endoscopic colostomy Interventional procedure overview of percutaneous endoscopic colostomy Interventional Procedures Overview - Percutaneous endoscopic sigmoid colostomy No last updated information available: null | false Guidance formats Web format Full Guidance (PDF) Percutaneous endoscopic colostomy Information for the public Implementation tools and resources None available See this guidance in practice Research recommendations Patient The summary of the key recommendations in the guidance written for patients, carers and those with little medical knowledge and may be used in local patient information leaflets. 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The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on percutaneous endoscopic colostomy.
Percutaneous endoscopic sigmoid colostomy (PEC) is a variation of the percutaneous endoscopic gastrostomy technique which has been well established for enteral gastric feeding since 1980.
A colonoscope is inserted into the left colon per rectum until transillumination is seen through the skin surface and finger pressure indents the colon. The PEG tube kit is passed through the scope with the snare. Under local anaesthesia, a small incision is made in the skin and a hollow needle is passed through the abdominal wall into the bowel. The snare passes over the visualised needle to grasp it and is then withdrawn with the wire and colonoscope through the anal canal.
A 20F catheter system is securely tied with wire and pulled retrogradely through the bowel and abdominal wall and is then secured against the abdominal wall. To check the final position of the catheter, the colonoscope is reinserted. The catheter is then attached to a drainage bag, flushed twice a day and antibiotics are administered for five days postoperatively. This tube can be in situ for the long term or short term, depending on indications for use.
PEC can be used:
PEC offers an alternative treatment for patients who have tried conventional treatment options without success. Various surgical techniques as an alternative to PEC include sigmoidopexy, sigmoidoplasty, trephine stoma to resection with primary anastomosis. Traditional treatment options for sigmoid volvulus comprise endoscopic decompression and/or open resection. However, these treatment options have varying success with endoscopic decompression having a recurrence rate of approximately 40% and open resection may be contraindicated for frail, elderly patients or the severely immunocompromised.
H15.7 Percutaneous endoscopic sigmoid colostomy
The NHS Classifications Service of NHS Connecting for Health is the central definitive source for clinical coding guidance and determines the coding standards associated with the classifications (OPCS-4 and ICD-10) to be used across the NHS. The NHS Classifications Service and NICE work collaboratively to ensure the most appropriate classification codes are provided. www.connectingforhealth.co.uk/clinicalcoding
No last updated information available: null | false
Information for the public
The summary of the key recommendations in the guidance written for patients, carers and those with little medical knowledge and may be used in local patient information leaflets.
The quick reference guide presents recommendations for health professionals
The published NICE clinical guidance, contains the recommendations for health professionals and NHS bodies.
The published full clinical guidance for specialists with background, evidence, recommendations and methods used.
Accessibility | Cymraeg | Freedom of information | Vision Impaired | Contact Us | Glossary | Data protection | Copyright | Disclaimer | Terms and conditions
Copyright 2013 National Institute for Health and Care Excellence. All rights reserved.