{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:45:10Z","timestamp":1792622710983,"version":"4.5.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2016,2,1]],"date-time":"2016-02-01T00:00:00Z","timestamp":1454284800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,2,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Faecal incontinence and constipation affects up to 20 per cent of the general population, and can be a significant source of distress. The antegrade continence enema (ACE) procedure has been shown to be an effective alternative treatment option for children, but its use in adults requires clarification. A systematic review and meta-analysis was performed to determine outcomes of the ACE procedure in adults with faecal incontinence and constipation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>PubMed, MEDLINE and the Cochrane Library (from January 1990 to January 2015) were searched for studies that reported outcomes of ACE in adults with faecal incontinence and constipation. The primary outcome measure was successful use of ACE in the management of symptoms, as determined by continued use at follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Seventeen observational studies involving 426 patients (265 female patients; median age 42 (range 17\u201384) years) with faecal incontinence (165 patients), constipation (209) or both (52), who had undergone the ACE procedure, were analysed. At a median follow-up of 39 months, the pooled success rate was 74\u00b73 (95 per cent c.i. 66\u00b71 to 82\u00b76) per cent (P &amp;lt; 0\u00b7001). For patients with faecal incontinence the pooled success rate was 83\u00b76 (75\u00b70 to 92\u00b71) per cent, compared with 67\u00b77 (55\u00b71 to 80\u00b73) per cent in patients with constipation (both P &amp;lt; 0\u00b7001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The ACE procedure is an effective long-term treatment option in patients with faecal incontinence and constipation, and should be considered before performing a definitive colostomy. Patients with faecal incontinence appear to respond better than those with constipation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs.10051","type":"journal-article","created":{"date-parts":[[2016,2,1]],"date-time":"2016-02-01T10:01:53Z","timestamp":1454320913000},"page":"322-327","source":"Crossref","is-referenced-by-count":35,"title":["Meta-analysis of antegrade continence enema in adults with faecal incontinence and constipation"],"prefix":"10.1093","volume":"103","author":[{"given":"D S Y","family":"Chan","sequence":"first","affiliation":[{"name":"Department of Surgery, Nevill Hall Hospital, Abergavenny NP7 7EG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R J","family":"Delicata","sequence":"additional","affiliation":[{"name":"Department of Surgery, Nevill Hall Hospital, Abergavenny NP7 7EG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2016,2,1]]},"reference":[{"key":"2021021817175994200_bjs10051-bib-0001","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1111\/j.1572-0241.2004.04114.x","article-title":"Epidemiology of constipation in North America: a systematic review","volume":"99","author":"Higgins","year":"2004","journal-title":"Am J Gastroenterol"},{"key":"2021021817175994200_bjs10051-bib-0002","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1001\/jama.300.11.1311","article-title":"Prevalence of symptomatic pelvic floor disorders in US women","volume":"300","author":"Nygaard","year":"2008","journal-title":"JAMA"},{"key":"2021021817175994200_bjs10051-bib-0003","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1053\/j.gastro.2003.10.010","article-title":"Epidemiology of fecal incontinence","volume":"126","author":"Nelson","year":"2004","journal-title":"Gastroenterology"},{"key":"2021021817175994200_bjs10051-bib-0004","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/j.bpg.2010.12.007","article-title":"Surgical treatment for constipation in children and adults","volume":"25","author":"Levitt","year":"2011","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"2021021817175994200_bjs10051-bib-0005","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1111\/j.1463-1318.2011.02797.x","article-title":"Rectal irrigation: a useful tool in the armamentarium for functional bowel disorders","volume":"14","author":"Chan","year":"2012","journal-title":"Colorectal Dis"},{"key":"2021021817175994200_bjs10051-bib-0006","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1097\/SLA.0b013e3181cf8ed0","article-title":"Sacral nerve stimulation for fecal incontinence: results of a 120-patient prospective multicenter study","volume":"251","author":"Wexner","year":"2010","journal-title":"Ann Surg"},{"key":"2021021817175994200_bjs10051-bib-0007","doi-asserted-by":"crossref","first-page":"e238","DOI":"10.1111\/j.1463-1318.2011.02651.x","article-title":"Antegrade colonic enema for faecal incontinence in adults: long-term results of 75 patients","volume":"13","author":"Ch\u00e9reau","year":"2011","journal-title":"Colorectal Dis"},{"key":"2021021817175994200_bjs10051-bib-0008","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1016\/0140-6736(90)92834-5","article-title":"Preliminary report: the antegrade continence enema","volume":"336","author":"Malone","year":"1990","journal-title":"Lancet"},{"key":"2021021817175994200_bjs10051-bib-0009","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1111\/j.1463-1318.2004.00669.x","article-title":"Long-term results of the antegrade continent enema procedure for constipation in adults","volume":"6","author":"Lees","year":"2004","journal-title":"Colorectal Dis"},{"key":"2021021817175994200_bjs10051-bib-0010","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1007\/s11938-004-0051-z","article-title":"Management of fecal incontinence in children without functional fecal retention","volume":"7","author":"Pensabene","year":"2004","journal-title":"Curr Treat Options Gastroenterol"},{"key":"2021021817175994200_bjs10051-bib-0011","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1016\/j.jpedsurg.2014.02.090","article-title":"Follow up of children undergoing antegrade continent enema: experience of over two hundred cases","volume":"49","author":"Randall","year":"2014","journal-title":"J Pediatr Surg"},{"key":"2021021817175994200_bjs10051-bib-0012","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.jpedsurg.2008.10.097","article-title":"What happens to children with idiopathic constipation who receive an antegrade continent enema? 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