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Long-term outcome of left- vs right-sided antegrade continence enema

 Hye Kyung Chang  ;  Eun Young Chang  ;  Seok Joo Han  ;  Seung Hoon Choi  ;  Jung-Tak Oh 
 Journal of Pediatric Surgery, Vol.47(10) : 1880-1885, 2012 
Journal Title
 Journal of Pediatric Surgery 
Issue Date
Child ; Colon, Sigmoid ; Constipation/surgery* ; Enema/methods* ; Fecal Incontinence/surgery* ; Female ; Humans ; Male ; Postoperative Complications/epidemiology ; Retrospective Studies ; Treatment Outcome
Malone antegrade continence enema ; Left antegrade continence enema ; Fecal continence ; Fecal incontinence
BACKGROUND/PURPOSE: This study compared long-term outcomes of left- vs right-sided antegrade continence enema (ACE) procedures. METHODS: We retrospectively analyzed medical records and performed a follow-up telephone survey of patients who underwent the ACE procedure at Severance Children's Hospital between 1999 and 2011. RESULTS: A total of 49 patients underwent 51 ACE procedures. The procedures were left-sided ACE in 25 patients (group 1) and right-sided in 26 patients (group 2), including 2 patients who underwent left-sided procedures a few years earlier. Fecal soiling was more common in group 1 than in group 2 (8/25 [32.0%] vs 1/26 [3.9%], respectively; P = .0109). Seven patients (28.0%) in group 1 had abdominal pain unrelieved by ACEs. Stomal reflux of fecal material was more frequent in group 1 than in group 2 (13/25 [52.0%] vs 0/26 [0%], respectively; P < .0001). Nonuse or infrequent use of ACE was more common in group 1 than in group 2 (11/25 [44.0%] vs 0/26 [0%], respectively; P < .0001). Patient satisfaction was higher in group 2 (P = .0015). CONCLUSIONS: In our experience using the sigmoid colon for left-sided ACE, right-sided ACE was superior to left-sided ACE in achieving fecal continence, resolving intractable constipation, and providing patient satisfaction.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Oh, Jung Tak(오정탁)
Chang, Eun Young(장은영)
Chang, Hye Kyung(장혜경)
Choi, Seung Hoon(최승훈)
Han, Seok Joo(한석주) ORCID logo https://orcid.org/0000-0001-5224-1437
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