Antegrade Continence Enema in the Treatment of Congenital Fecal Incontinence Beyond Childhood

Abstract

Despite numerous complications and occasional treatment failures, 90 percent of adult patients with congenital fecal incontinence benefited from antegrade continence enema.

Meta-analysis of antegrade continence enema in adults with faecal incontinence and constipation

“…All studies analysed were observational cohorts, of which three had a prospective design. Five studies included patients with faecal incontinence, seven included patients with constipation and five studies included patients with both symptoms ( Table ). Various ACE procedures were used in the studies.…”

Antegrade continence enema procedure: impact on quality of life in patients with spinal cord injury

“…Stomal stenosis requiring revision occurred in 18% (3/17) of our patients, which is comparable to that reported in other series. [5][6][7]17 One patient (6%) in our series developed a delayed smallbowel obstruction, which required surgical exploration. The risk of major complications following the ACE procedure, although low, underscores the role of proper preoperative counseling.…”

“…The ACE procedure allows a patient to administer an enema directly into the cecum via an easily accessible abdominal wall stoma, and it is an effective method for controlling refractory fecal incontinence due to a variety of etiologies in both adult and pediatric populations. [5][6][7][8][9] The ACE procedure has been shown to provide significant improvement in patient and caregiver quality of life (QOL) when used in patients with neurogenic bowel dysfunction due to a variety of etiologies; however, no study has assessed the impact of the ACE procedure on QOL in patients with neurogenic bowel dysfunction due to SCI. [10][11][12] We use a validated QOL instrument, which specifically assesses QOL related to fecal incontinence, to objectively measure changes in QOL related to fecal incontinence before and after the ACE procedure in patients with SCI.…”

Use of Antegrade Continence Enema for the Treatment of Fecal Incontinence and Functional Constipation in Adults

“…the difference in results in these 2 studies probably reflects the different patient groups being compared. Chéreau et al 55 investigated patients with adult-onset fi compared with Koivusalo et al, 54 where the outcomes in adult patients with congenital fi were reported. in the latter study, more than half of the patients had undergone previous abdominal surgery, putting them at risk for intra-abdominal complications.…”