Long-term results of antegrade colonic enema in adult patients: assessment of functional results.
OBJECTIVE
This retrospective study reviewed long-term results in a large group of adult patients treated with antegrade colonic enema and antegrade colonic enema combined with a colostomy.


METHODS
Retrospective chart review identified 80 patients (64 females, mean age 51) surgically treated between 1993 and 2007 for fecal incontinence or constipation. Surgical treatments included 69 appendicostomies, 13 tapered ileum, 3 cecal tube, and 25 appendicostomy/neoappendicostomy combined with a colostomy. A 44-item questionnaire was mailed considering bowel regimen, complications, bowel function, social function, and quality of life.


RESULTS
Sixty-nine patients were available for follow-up (mean follow-up, 75 months). Thirty patients (38 percent) had surgical complications. Forty-three patients (62 percent) were still performing antegrade continence enema and 8 patients (12 percent) no longer needed it. Accordingly, treatment was successful in 51 patients (74 percent). Twenty-seven patients (63 percent) had side effects. Evaluation of bowel function, social function, and quality of life all showed significant improvement. Antegrade continence enema was successful in patients with neurologic disabilities (67 percent), anorectal injury (53 percent), idiopathic fecal incontinence (50 percent), and idiopathic fecal constipation (42 percent). Antegrade continence enema was successful in patients with constipation, incontinence, and mixed symptoms. Results did not differ between appendicostomy, neoappendicostomy, and the combined appendicostomy/neoappendicostomy and colostomy.


CONCLUSIONS
Long-term results were favorable in most patients treated with antegrade continence enema for fecal incontinence or constipation.
Worsøe
J
J
Department of Surgery P, Aarhus University Hospital, Aarhus, Denmark. drworlagovicz@hotmail.com
Christensen
P
P
Krogh
K
K
Buntzen
S
S
Laurberg
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D003125:Colostomy; D003248:Constipation / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D003672:Defecation / Q000502:physiology*; D004733:Enema / Q000009:adverse effects / Q000379:methods*; D005242:Fecal Incontinence / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011788:Quality of Life; D020127:Recovery of Function; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome