5 years after an ACE: what happens then?

Area of Science:

• Pediatric surgery
• Gastroenterology
• Colorectal surgery

Background:

• Antegrade continence enema (ACE) significantly improved management for children with chronic constipation and soiling.
• Questions frequently arise regarding the long-term necessity of ACE therapy.

Purpose of the Study:

• To evaluate the duration of ACE use in pediatric patients.
• To assess long-term outcomes of ACE therapy over 5 years post-formation.

Main Methods:

• A retrospective review of clinical notes for patients who underwent ACE procedures between January 1990 and December 2010.
• Inclusion criteria required a minimum of 5 years of follow-up data.

Main Results:

• 133 patients with over 5 years of follow-up were analyzed.
• 74% of patients continued ACE use, while 26% discontinued.
• Excellent clinical outcomes were achieved in 86% of patients, with outcomes varying by primary diagnosis (e.g., Hirschsprung's Disease, functional constipation).

Conclusions:

• The majority of pediatric patients maintain ACE therapy long-term, achieving high rates of excellent clinical outcomes.
• While ACE is effective, long-term outcomes are diagnosis-dependent, with functional constipation showing a higher failure rate.
• ACE therapy remains a valuable intervention for managing chronic constipation and soiling in children.