5 years after an ACE: what happens then?
- Resource Type
- journal article
- Authors
- Chong, Clara; Featherstone, Neil; Sharif, Shazia; Cherian, Abraham; Cuckow, Peter; Mushtaq, Imran; Coppi, Paolo; Cross, Kate; Curry, Joseph; De Coppi, Paolo
- Source
- Pediatric Surgery International. Apr2016, Vol. 32 Issue 4, p397-401. 5p. 3 Charts.
- Subject
- *ENEMA
*ENTEROCLYSIS
*CONSTIPATION
*FOLLOW-up studies (Medicine)
*HEALTH outcome assessment
- Language
- ISSN
- 0179-0358
Purpose: Antegrade continence enema (ACE) revolutionised the lives of children with chronic constipation and soiling. Parents often ask how long the ACE will be required. We looked at our patients 5 years after ACE formation to answer the question.Methods: We reviewed clinical notes of all patients undergoing ACE procedure during January 1990 to December 2010. Only patients with >5 years follow-up were included. Data are given as median (range).Results: 133 patients were included with >5 years of follow-up. Primary pathology was anorectal anomaly (ARA) 64 (48%); spinal dysraphism (SD) 40 (30%); functional constipation (FC) 14 (10%); Hirschsprung's Disease (HD) 10 (8%) and others 5 (4%). Median follow-up was 7 years (5-17 years). Overall 74% still use their ACE; whilst 26% no longer access their stoma, of whom 47% recovered normal colonic function. 50% of HD patient recover colonic function. FC has the highest failure rate at 21%.Conclusions: Overall 86% achieved excellent clinical outcome with 74% of patient still using their ACE at 5 years. HD has the highest recovery rate of 50%. FC has a more unreliable clinical outcome with 21% recovered colonic function and 21% failed. Outcome varied dependent on the background diagnosis. [ABSTRACT FROM AUTHOR]