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The first 5-year follow up of distal antegrade continence enema stomas
S C Blackburn1, J R Fishman, N Geoghegan
1Chelsea and Westminster Hospital, London, UK. sblackburn@doctors.org.uk
Insights
Long-term results of distal antegrade continence enema (DACE) show encouraging outcomes. Many patients continue DACE therapy for years with high satisfaction and reduced soiling, demonstrating its effectiveness.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Urology
Background:
- Distal antegrade continence enema (DACE) is a surgical procedure for fecal incontinence.
- Long-term outcomes of DACE are not well-established.
Purpose of the Study:
- To investigate the 5-year outcomes of patients with DACE.
- To assess the efficacy, patient satisfaction, and long-term success of DACE.
Main Methods:
- Retrospective review of patients with DACE placed over 5 years prior.
- Telephone questionnaires administered to patients and parents regarding DACE use, satisfaction, and outcomes.
Main Results:
- 15 of 28 respondents were still using DACE after a median of 92 months.
- 85% of patients would recommend DACE, with high satisfaction scores (median 8/10).
- Significant reduction in soiling reported by active DACE users.
Conclusions:
- This study provides the first 5-year follow-up data for DACE.
- DACE demonstrates encouraging long-term results and high patient satisfaction for managing fecal incontinence.
Aim:
We investigated 5-year results of distal sites for antegrade continence enemas (DACE).
Methods:
Patients with DACE sites placed more than 5 years previously were identified. Details of procedures were obtained. Parents, and patients over 18, were telephoned and asked to answer a standardised questionnaire.
Results:
31 patients were identified. Median age at DACE placement was 7 years (range 3-20). Median follow up was 92 months (range 66-145). 22 tubes were placed endoscopically, 7 were placed at open surgery and 2 at laparoscopic surgery. 28 responses to the telephone questionnaire were obtained. Of these, 15 were still using their DACE and 13 had stopped. Of those who had ceased washouts: 7 reported resolution of symptoms, 4 had a colostomy, 1 an ileostomy and 1 patient had abandoned their DACE. In patients using their stoma, washouts took a median of 5 min, with a median time to result of 25 min. 10 patients reported no soiling, 4 monthly and 1 daily soiling. Median satisfaction score was 8/10 (range 1-10/10). 24 (85%) said that they would recommend a DACE.
Conclusions:
This is the first report of 5-year follow up of a series of patients performing DACE washouts. The results are encouraging.
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