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Related Experiment Videos

Early experience with the laparoscopic ace procedure.

R W Robertson1, A C Lynch, S W Beasley

  • 1Department of Paediatric Surgery, Christchurch Hospital, New Zealand.

The Australian and New Zealand Journal of Surgery
|May 18, 1999
PubMed
Summary
This summary is machine-generated.

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The laparoscopic antegrade continence enema (ACE) procedure improves fecal continence in children. This minimally invasive technique offers a simpler, effective solution for managing fecal incontinence with satisfactory outcomes.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology

Background:

  • The reversed appendicocaecostomy technique, introduced in 1990, facilitates antegrade continence enema (ACE) administration for fecal incontinence in children.
  • Modifications include direct suturing of the appendix to the skin as a stoma, with laparoscopic approaches now available.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of laparoscopic antegrade continence enema (ACE) procedures in managing fecal incontinence in children.
  • To assess intra-operative, postoperative complications, and caregiver experiences with the laparoscopic ACE procedure.

Main Methods:

  • Retrospective review of children undergoing laparoscopic ACE procedures at Christchurch Hospital and Princess Margaret Hospital.
  • Analysis of intra-operative/postoperative complications and caregiver-reported management experiences via questionnaires.

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Main Results:

  • Twenty-nine of thirty children successfully use the stoma for antegrade colonic washouts.
  • Improved continence was observed in 27 children, with 15 achieving complete continence.
  • Stoma stenosis occurred in eight children, managed conservatively or with revision; two experienced leaks.

Conclusions:

  • Laparoscopic ACE provides an improved level of continence for children with fecal incontinence.
  • The procedure is a simpler alternative with minimal morbidity, offering satisfactory outcomes for patients and families.