{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:33:40Z","timestamp":1777588420512,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2022,4,1]],"date-time":"2022-04-01T00:00:00Z","timestamp":1648771200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology"],"published-print":{"date-parts":[[2022,4]]},"abstract":"\n Introduction:<\/jats:title>\n We present perioperative outcomes of a single-center experience with robot-assisted antegrade colonic enema (ACE) channel creation for the treatment of chronic constipation refractory to medical therapy and compare it to the traditional open surgical approach. We also demonstrate a step-by-step video presentation of the robotic approach for cecal flap ACE performed as part of a dual continence procedure in patients with short length of appendix.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n A retrospective chart review of pediatric patients who underwent ACE channel creation between 2008 and 2020 was performed. We compared demographics and intraoperative and postoperative variables of the open\n vs<\/jats:italic>\n robotic approach.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Among 28 patients, 15 were open and 13 robotic. To construct the ACE channel, a cecal flap was utilized in 36%, split appendix in 50%, full-length appendix in 11%, and sigmoid colon in 3% of patients. Both approaches showed equivalent estimated blood loss (50\u2009mL [interquartile range; IQR\u2009=\u200920\u2013100]), median length of hospital stay (7 days\n vs<\/jats:italic>\n 8 days,\n p<\/jats:italic>\n \u2009=\u20090.7), and median time to return to regular diet (4 days\n vs<\/jats:italic>\n 5 days,\n p<\/jats:italic>\n \u2009=\u20090.5) (\n Table 1<\/jats:xref>\n ). Patients in the open group were more likely to have a history of prior abdominal surgeries than those in the robotic group (80%\n vs<\/jats:italic>\n 38.5%,\n p<\/jats:italic>\n \u2009=\u20090.02). The risk of Clavien-Dindo grade 3 or more complications (40%\n vs<\/jats:italic>\n 23.1%,\n p<\/jats:italic>\n \u2009=\u20090.04) and the rate of ACE channel stenosis (46.7%\n vs<\/jats:italic>\n 7.7%,\n p<\/jats:italic>\n \u2009=\u20090.02) were significantly higher in the open approach. Channel stenosis was significantly higher in patients with an appendix ACE channel (87.5%\n vs<\/jats:italic>\n 12.5%,\n p<\/jats:italic>\n \u2009<\u20090.05) compared to those with cecal flap ACE.\n <\/jats:p>\n \n \n Table 1.<\/jats:label>\n \n Demographic, Operative Characteristics, and Complications Among Patients Undergoing Antegrade Colonic Enema and Comparison Between Open Approach and Robotic Approach<\/jats:p>\n <\/jats:caption>\n \n \n \n \n \n \n \n \n \n \n <\/jats:colgroup>\n \n \n \n Total<\/jats:th>\n Open<\/jats:th>\n Robotic<\/jats:th>\n p<\/jats:th>\n <\/jats:tr>\n <\/jats:thead>\n \n \n Patients<\/jats:td>\n 28<\/jats:td>\n 15<\/jats:td>\n 53.60%<\/jats:td>\n 13<\/jats:td>\n 46.40%<\/jats:td>\n 0.027<\/jats:td>\n <\/jats:tr>\n \n Age, median (IQR)<\/jats:td>\n 9 (6\u201314)<\/jats:td>\n 6<\/jats:td>\n (5\u201311.5)<\/jats:td>\n 12<\/jats:td>\n (9\u201314)<\/jats:td>\n <\/jats:tr>\n \n Preoperative diagnosis<\/jats:td>\n <\/jats:tr>\n \n \u2003Spinal dysraphism<\/jats:td>\n 26<\/jats:td>\n 14<\/jats:td>\n 93.30%<\/jats:td>\n 12<\/jats:td>\n 92.30%<\/jats:td>\n 0.92<\/jats:td>\n <\/jats:tr>\n \n \u2003Cerebral palsy<\/jats:td>\n 2<\/jats:td>\n 1<\/jats:td>\n 6.70%<\/jats:td>\n 1<\/jats:td>\n 7.70%<\/jats:td>\n <\/jats:tr>\n \n Prior abdominal procedure<\/jats:td>\n 17<\/jats:td>\n 12<\/jats:td>\n 80.00%<\/jats:td>\n 5<\/jats:td>\n 38.50%<\/jats:td>\n 0.025<\/jats:td>\n <\/jats:tr>\n \n Procedures<\/jats:td>\n <\/jats:tr>\n \n \u2003ACE<\/jats:td>\n 28<\/jats:td>\n 15<\/jats:td>\n 100.00%<\/jats:td>\n 13<\/jats:td>\n 100.00%<\/jats:td>\n \n <\/jats:tr>\n \n \u2003APV<\/jats:td>\n 19<\/jats:td>\n 8<\/jats:td>\n 53.30%<\/jats:td>\n 11<\/jats:td>\n 84.60%<\/jats:td>\n 0.077<\/jats:td>\n <\/jats:tr>\n \n \u2003Monti<\/jats:td>\n 5<\/jats:td>\n 5<\/jats:td>\n 33.30%<\/jats:td>\n 0<\/jats:td>\n 0.00%<\/jats:td>\n 0.044<\/jats:td>\n <\/jats:tr>\n \n \u2003BA<\/jats:td>\n 16<\/jats:td>\n 7<\/jats:td>\n 46.70%<\/jats:td>\n 9<\/jats:td>\n 69.20%<\/jats:td>\n 0.25<\/jats:td>\n <\/jats:tr>\n \n \u2003Bladder neck reconstruction<\/jats:td>\n 8<\/jats:td>\n 6<\/jats:td>\n 40.00%<\/jats:td>\n 2<\/jats:td>\n 15.40%<\/jats:td>\n 0.15<\/jats:td>\n <\/jats:tr>\n \n \u2003Bladder neck closure<\/jats:td>\n 2<\/jats:td>\n 0<\/jats:td>\n 0.00%<\/jats:td>\n 2<\/jats:td>\n 15.40%<\/jats:td>\n 0.22<\/jats:td>\n <\/jats:tr>\n \n ACE channel technique<\/jats:td>\n <\/jats:tr>\n \n \u2003Appendix<\/jats:td>\n 3<\/jats:td>\n 1<\/jats:td>\n 6.70%<\/jats:td>\n 2<\/jats:td>\n 15.40%<\/jats:td>\n 0.53<\/jats:td>\n <\/jats:tr>\n \n \u2003Split appendix<\/jats:td>\n 14<\/jats:td>\n 7<\/jats:td>\n 46.70%<\/jats:td>\n 7<\/jats:td>\n 53.80%<\/jats:td>\n 0.71<\/jats:td>\n <\/jats:tr>\n \n \u2003Cecal flap<\/jats:td>\n 10<\/jats:td>\n 6<\/jats:td>\n 40.00%<\/jats:td>\n 4<\/jats:td>\n 30.80%<\/jats:td>\n 0.62<\/jats:td>\n <\/jats:tr>\n \n \u2003Sigmoid colon<\/jats:td>\n 1<\/jats:td>\n 1<\/jats:td>\n 6.70%<\/jats:td>\n 0<\/jats:td>\n 0.00%<\/jats:td>\n 0.96<\/jats:td>\n <\/jats:tr>\n \n Estimated blood loss (mL), median (IQR)<\/jats:td>\n 50 (20\u2013100)<\/jats:td>\n 50<\/jats:td>\n (35\u201375)<\/jats:td>\n 50<\/jats:td>\n (20\u2013100)<\/jats:td>\n 0.93<\/jats:td>\n <\/jats:tr>\n \n Return to diet, median (IQR)<\/jats:td>\n 4 (3\u20137)<\/jats:td>\n 5<\/jats:td>\n (3\u20137)<\/jats:td>\n 4<\/jats:td>\n (3\u20134)<\/jats:td>\n 0.5<\/jats:td>\n <\/jats:tr>\n \n Length of hospital stay, median (IQR)<\/jats:td>\n 7 (6\u201310)<\/jats:td>\n 8<\/jats:td>\n (7\u201311)<\/jats:td>\n 7<\/jats:td>\n (6\u201310)<\/jats:td>\n 0.74<\/jats:td>\n <\/jats:tr>\n \n Complications<\/jats:td>\n <\/jats:tr>\n \n \u2003ACE suprafascial stomal stenosis<\/jats:td>\n 4<\/jats:td>\n 4<\/jats:td>\n 26.70%<\/jats:td>\n 0<\/jats:td>\n 0.00%<\/jats:td>\n 0.11<\/jats:td>\n <\/jats:tr>\n \n \u2003ACE subfascial stomal stenosis<\/jats:td>\n 4<\/jats:td>\n 3<\/jats:td>\n 20.00%<\/jats:td>\n 1<\/jats:td>\n 7.70%<\/jats:td>\n 0.45<\/jats:td>\n <\/jats:tr>\n \n Total ACE channel stenosis<\/jats:td>\n 8<\/jats:td>\n 7<\/jats:td>\n 46.70%<\/jats:td>\n 1<\/jats:td>\n 7.70%<\/jats:td>\n 0.023<\/jats:td>\n <\/jats:tr>\n \n ACE channel-related Clavien grade 3 or more complication (0: No, 1: Yes)<\/jats:td>\n 9<\/jats:td>\n 6<\/jats:td>\n 40.00%<\/jats:td>\n 3<\/jats:td>\n 23.10%<\/jats:td>\n 0.037<\/jats:td>\n <\/jats:tr>\n <\/jats:tbody>\n <\/jats:table>\n <\/jats:alternatives>\n <\/jats:table-wrap>\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Robot-assisted ACE channel creation is a safe and acceptable alternative with a significantly lower rate of channel stenosis and other clavien dindo grade 3 complications compared to the traditional open approach. Cecal flaps are also at a lower risk of stomal stenosis than appendix.<\/jats:p>\n <\/jats:sec>","DOI":"10.1089\/end.2021.0403","type":"journal-article","created":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T05:15:31Z","timestamp":1640063731000},"page":"462-467","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Antegrade Colonic Enema Channels in Pediatric Patients Using Appendix or Cecal Flap: A Comparative Robotic\n vs<\/i>\n Open Series"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0210-9336","authenticated-orcid":false,"given":"Ragheed","family":"Saoud","sequence":"first","affiliation":[{"name":"Section of Urology, Department of Surgery, University of Chicago Medicine, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nassib","family":"Abou Heidar","sequence":"additional","affiliation":[{"name":"American University of Beirut Medical Center, Beirut, Lebanon."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ciro","family":"Andolfi","sequence":"additional","affiliation":[{"name":"Section of Urology, Department of Surgery, University of Chicago Medicine, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohan S.","family":"Gundeti","sequence":"additional","affiliation":[{"name":"Section of Urology, Department of Surgery, University of Chicago Medicine, Chicago, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,4,1]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2013.04.009"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpurol.2016.04.020"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2013.01.045"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(90)92834-5"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-006-0732-x"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181b13ca2"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2013.111"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s003830050342"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)92467-8"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2020.08.013"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2010.09803.x"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2010.0181"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1089\/lap.2007.0083"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2008.0256"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2008.04.024"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0030-1265156"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-004-1220-9"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1285874"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2006.10.045"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1055319"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1463-1318.2003.00403.x"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1055318"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2009.02006.x"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2020.01.011"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2018.10.008"},{"key":"e_1_3_5_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000428"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2008.10.097"}],"container-title":["Journal of Endourology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/end.2021.0403","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/end.2021.0403","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/end.2021.0403","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T20:14:09Z","timestamp":1777407249000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/end.2021.0403"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":27,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1089\/end.2021.0403"],"URL":"https:\/\/doi.org\/10.1089\/end.2021.0403","relation":{},"ISSN":["0892-7790","1557-900X"],"issn-type":[{"value":"0892-7790","type":"print"},{"value":"1557-900X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4]]}}}