Long-term outcome of left- vs right-sided antegrade continence enema

Chang, Hye Kyung; Chang, Eun Young; Han, Seok Joo; Choi, Seung Hoon; Oh, Jung Tak

doi:10.1016/j.jpedsurg.2012.05.031

Cited by 8 publications

(6 citation statements)

References 18 publications

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“…Several variants of enemas are used, and transanal irrigation (TAI) with tap water is often effective at relieving symptoms of constipation, but time‐consuming and difficult to perform without assistance . Antegrade colonic/continent enemas (ACE) through an appendicostomy have gained in popularity , due to its positive effects on symptoms and quality of life and the low complication rate . In a group (n = 61) using ACE, 40% had abandoned the method after a median of 11 years, but those still using ACE were highly satisfied .…”

Section: Introductionmentioning

confidence: 99%

Independence does not come with the method – treatment of neurogenic bowel dysfunction in children with myelomeningocele

et al. 2014

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Section: Introductionmentioning

confidence: 99%

Independence does not come with the method – treatment of neurogenic bowel dysfunction in children with myelomeningocele

et al. 2014

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“…Nonuse and infrequent use of ACE, defined as approximately less than once in 1–2 weeks, occurred in 11 of 25 patients in the left‐sided group and 0 of 26 patients in the right‐sided group. The authors reported that the nonuse and infrequent use was primarily due to unresolved soiling 49 . Together, these studies regarding adherence, post‐surgical complications, and level of continence indicate that early success with continence post‐procedure may be important for setting patients and families up for long‐term adherence with flushes.…”

Section: Post‐operative Factorsmentioning

confidence: 99%

“…One study comparing leftsided and right-sided ACE found the right-sided group achieved greater fecal continence (96% compared to 68%). 49 Nonuse and infrequent use of ACE, defined as approximately less than once in 1-2 weeks, occurred in 11 of 25 patients in the left-sided group and 0 of 26 patients in the right-sided group. The authors reported that the nonuse and infrequent use was primarily due to unresolved soiling.…”

Section: Treatment Adherencementioning

confidence: 99%

“…Learned helplessness refers to when an individual experiences repeated failure in resolving or escaping an aversive situation, so they stop trying. One study comparing left‐sided and right‐sided ACE found the right‐sided group achieved greater fecal continence (96% compared to 68%) 49 . Nonuse and infrequent use of ACE, defined as approximately less than once in 1–2 weeks, occurred in 11 of 25 patients in the left‐sided group and 0 of 26 patients in the right‐sided group.…”

Section: Post‐operative Factorsmentioning

confidence: 99%

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Psychosocial factors impacting antegrade continence enema outcomes in pediatric patients

Benson

Bazier

Schwartzkopf

et al. 2023

Neurogastroenterology Motil

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BackgroundChildren with constipation and encopresis are often treated with medication and behavioral approaches. When constipation persists, surgical interventions such as antegrade continence enema (ACE) procedures are considered. Many children benefit from these procedures; however, some children continue to have incontinence, experience complications, or discontinue the use of the ACE stoma. There is some evidence in the literature to indicate that psychosocial factors can have an impact on ACE outcomes; however, standardized biopsychosocial guidelines related to ACE candidacy and surgery do not currently exist.PurposeThe purpose of this review is to summarize the research to date on psychosocial factors related to ACE treatment outcomes and complications. Identifying what is known and what limitations remain can support future research to inform development of guidelines for pre‐procedure evaluations. Psychosocial pre‐procedure evaluations could help to inform eligibility for the procedure as well as interventions to enhance outcomes for children at increased risk for poor outcomes or complications from ACE. Age, psychiatric symptoms, and adherence to the ACE flush regimen were some of the factors identified in the literature as impacting ACE outcomes; however, there is limited research in this area.

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“…66 However, left-sided ACE may not be as effective in resolving constipation and achieving continence. 67 Our preference is to perform a laparoscopic-assisted percutaneous endoscopic cecostomy (LAPEC). 68 We have modified our original procedure and now place a balloon-type button at the initial operation.…”

Section: Antegrade Colonic Enemamentioning

confidence: 99%

Surgical Management of Idiopathic Constipation in Pediatric Patients

Cheng

Goldstein

2018

Clinics in Colon and Rectal Surgery

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Constipation is a common childhood problem, but an anatomic or physiologic cause is identified in fewer than 5% of children. By definition, idiopathic constipation is a diagnosis of exclusion. Careful clinical evaluation and thoughtful use of imaging and other testing can help exclude specific causes of constipation and guide therapy. Medical management with laxatives is effective for the majority of constipated children. For those patients unresponsive to medications, however, several surgical options can be employed, including anal procedures, antegrade colonic enemas, colorectal resection, and intestinal diversion. Judicious use of these procedures in properly selected patients and based on appropriate preoperative testing can lead to excellent outcomes. This review summarizes the surgical options available for managing refractory constipation in children and provides guidance on how to choose the best procedure for a given patient.

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Long-term outcome of left- vs right-sided antegrade continence enema

Cited by 8 publications

References 18 publications

Independence does not come with the method – treatment of neurogenic bowel dysfunction in children with myelomeningocele

Independence does not come with the method – treatment of neurogenic bowel dysfunction in children with myelomeningocele

Psychosocial factors impacting antegrade continence enema outcomes in pediatric patients

Surgical Management of Idiopathic Constipation in Pediatric Patients

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