Antegrade continence enema (ACE): predictors of outcome in 111 patients.
Pediatr Surg Int
; 30(11): 1135-41, 2014 Nov.
Article
in En
| MEDLINE
| ID: mdl-25287377
ABSTRACT
PURPOSE:
The antegrade continence enema (ACE) is used as a means of managing faecal incontinence and constipation with varying outcomes. We aim to evaluate our outcomes of ACEs and identify predictors of outcome.METHODS:
A retrospective case-note review of patients ≤16 years of age undergoing an ACE (March 2000-September 2013) was carried out. Data collected included patient demographics, functional outcomes and complications. Data are quoted as median (range) and compared using Mann-Whitney and Fisher's exact test. Univariate analysis was performed to identify predictors of successful outcomes. P < 0.05 is significant. Successful outcome = total continence/occasional leakage and failed outcome = regular soiling and/or constipation.RESULTS:
111 patients with complete data sets underwent an ACE [59% male, median age = 9.5 years (3.4-16 years)] and median follow-up = 48 months (4 months-11 years 4 months). Underlying diagnoses were idiopathic constipation (n = 68), anorectal malformation (n = 27), neuropathic bowel (n = 7), Hirschsprung disease (n = 5) and gastrointestinal dysmotility (n = 4). Social continence was achieved in 87/111 (78%). Fifteen percent of patients underwent reversal of ACE due to resolution of symptoms. There was no difference in outcomes related to diagnosis, gender, age or follow-up duration. Complication rate was 20.7% (23/111).CONCLUSIONS:
The ACE is safe and effective in the management of intractable constipation and soiling. No predictors of outcome were identified.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Digestive System Surgical Procedures
/
Constipation
/
Enema
/
Fecal Incontinence
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
Language:
En
Journal:
Pediatr Surg Int
Journal subject:
PEDIATRIA
Year:
2014
Type:
Article