{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T22:45:40Z","timestamp":1792622740119,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2011,5,1]],"date-time":"2011-05-01T00:00:00Z","timestamp":1304208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K24DK082792A"],"award-info":[{"award-number":["K24DK082792A"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2011,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background:<\/jats:title><jats:p>Antegrade continence enema (ACE) has become an important therapeutic modality in the treatment of intractable constipation and fecal incontinence. There are little data available on the long\u2010term performance of the ACE procedure in children.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>A retrospective review of patients who underwent the ACE procedure was conducted. Irrigation characteristics and complications were noted. Outcome was assessed for individual encounters based on frequency of bowel movements, incontinence, pain, and predictability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>One hundred seventeen patients underwent an ACE. One hundred five patients had at least 6 months of follow\u2010up, and were included in the analysis. Diagnoses included myelodysplasia (39%), functional intractable constipation (26%), anorectal malformations (21%), nonrelaxing internal anal sphincter (7%), cerebral palsy (3%), and other diagnoses (4%). The average follow\u2010up was 68 months (range 7\u2013178 months). At the last follow\u2010up, 69% of patients had successful bowel management. Of the 31% of patients who did not have successful bowel management, 20% were using the ACE despite suboptimal results, 10% required surgical removal, and 2% were not using the ACE because of behavioral opposition to it. Patients were started on normal saline, but were switched to GoLYTELY (PEG\u20103350 and electrolyte solution) if there was an inadequate response (61% at final encounter). Additives were needed in 34% of patients. The average irrigation dose was 23 \u00b1 0.7 mL\/kg. The average toilet sitting time was 51.7 \u00b1 3.5 minutes, with infusions running for 12.1 \u00b1 1.2 minutes. Stomal complications occurred in 63% (infection, leakage, and stenosis) of patients, 33% required surgical revision and 6% eventually required diverting ostomies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>Long\u2010term use of the ACE gives successful results in 69% of patients, whereas 63% had a stoma\u2010related complication and 33% required surgical revision of the stoma.<\/jats:p><\/jats:sec>","DOI":"10.1097\/mpg.0b013e3181ff6042","type":"journal-article","created":{"date-parts":[[2011,3,25]],"date-time":"2011-03-25T04:49:21Z","timestamp":1301028561000},"page":"574-580","source":"Crossref","is-referenced-by-count":75,"title":["Long\u2010term Follow\u2010up of Patients After Antegrade Continence Enema Procedure"],"prefix":"10.1002","volume":"52","author":[{"given":"Anees A","family":"Siddiqui","sequence":"first","affiliation":[{"name":"Center for Motility and Functional Gastrointestinal Disorders USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven J","family":"Fishman","sequence":"additional","affiliation":[{"name":"Department of Surgery USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart B","family":"Bauer","sequence":"additional","affiliation":[{"name":"Department of Urology Children's Hospital Boston Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Nurko","sequence":"additional","affiliation":[{"name":"Center for Motility and Functional Gastrointestinal Disorders 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