Is the outcome of the left colon antegrade continence enema better than that of the right colon antegrade continence enema?
OBJECTIVE
The purpose of this report was to review the results of the antegrade continence enema (ACE) procedure and to compare the outcomes of right and left colon ACEs in children.


METHODS
Thirty patients who underwent an ACE between 1998 and 2005 were analyzed. Data were obtained based on the following parameters: postoperative soiling, catheter insertion time, colonic washout time, quality of life, and abdominal pain during and after the ACE. Twenty-nine patients were followed for an average of 3.8 years (range, 4 months-7.3 years).


RESULTS
Right colon ACEs were performed in 23 patients, and left colon ACEs were performed in 7 patients. The common complications of the ACE included abdominal pain during and after the ACE (51.7%) and stoma strictures (41.4%). The overall ACE success rate was 24/29 (82.8%; right colon ACE, 18/29; left colon ACE, 6/29). Twenty-three patients (95.8%) believed their quality of life was improved. There were no significant differences in complications or outcomes between the right and left ACEs.


CONCLUSIONS
An ACE is an effective treatment for children with fecal incontinence. A left colon ACE has similar efficacy as a right colon ACE in managing fecal incontinence in children.
Kim
Hyun-Young
HY
Department of Surgery, Gacheon University of Medicine and Science, Incheon, Korea.
Jung
Sung-Eun
SE
Lee
Seong-Cheol
SC
Park
Kwi-Won
KW
Kim
Woo-Ki
WK
D015746:Abdominal Pain / Q000209:etiology / Q000503:physiopathology; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D044682:Colon, Ascending / Q000601:surgery; D044683:Colon, Descending / Q000601:surgery; D003248:Constipation / Q000175:diagnosis / Q000601:surgery* / Q000628:therapy; D013505:Digestive System Surgical Procedures / Q000379:methods; D004733:Enema / Q000009:adverse effects / Q000379:methods*; D005242:Fecal Incontinence / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011336:Probability; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D054047:Surgical Stomas; D016896:Treatment Outcome