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Updated: May 17, 2026

Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Long-term outcome of left- vs right-sided antegrade continence enema
Hye Kyung Chang1, Eun Young Chang, Seok Joo Han
1Department of Pediatric Surgery, Severance Children's Hospital, Yonsei University College of Medicine, Seoul 120-752, South Korea.
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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