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We aimed to describe the experience of a single-center pediatric cohort in a low-middle-income country (LMIC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of all ACE procedures performed between 2012 and 2026 was conducted. Demographics, diagnoses, indications, complications, surgeries, and functional outcomes (assessed with Milan Bowel Function Questionnaire) were collected from clinical and operative records. Descriptive statistics were applied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Forty-five children (80% male) underwent ACE procedures, with a median age of 8.3 years. Most had appendicostomy; two required cecostomy intraoperatively. The most common diagnosis was anorectal malformation (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200933, 73.3%), followed by neurogenic bowel (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097, 15.5%). Eight patients (17.7%) underwent a concomitant Mitrofanoff procedure. The main complication was skin-level stricture (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200917, 37.8%), representing the only indication for surgical revision (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915, 33.3%), with a median time to revision of 5.5 months. Nearly all patients achieved clinical success, with high satisfaction reported on the questionnaire.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ACE appendicostomy is an effective and satisfactory option in LMICs, with outcomes comparable to high-income settings, supported by careful patient selection and ongoing quality improvement efforts.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00383-026-06533-0","type":"journal-article","created":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T11:12:07Z","timestamp":1783854727000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes and revision rates after antegrade continence enema (ACE) appendicostomy in a single-center LMIC paediatric cohort"],"prefix":"10.1007","volume":"42","author":[{"given":"C.","family":"Campilongo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Trovalusci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Hartford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Bebington","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Westgarth-Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Brisighelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,12]]},"reference":[{"issue":"1","key":"6533_CR1","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1016\/j.jpedsurg.2018.10.008","volume":"54","author":"DR Halleran","year":"2019","unstructured":"Halleran DR, Vilanova-Sanchez A, Rentea RM et al (2019) A comparison of Malone appendicostomy and cecostomy for antegrade access as adjuncts to a bowel management program for patients with functional constipation or fecal incontinence. 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