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Reducing Constipation-Related Admissions: The Effectiveness of Antegrade Continence Enema Procedures in Children

Joseph R Esparaz1,2, Alicia M Waters1,2, Michelle S Mathis1

  • 1Division of Pediatric Surgery, 22078Children's of Alabama, Birmingham, AL, USA.

The American Surgeon
|June 1, 2021
PubMed

Insights

Antegrade continence enema (ACE) procedures significantly reduced hospital admissions for pediatric constipation. This approach improves symptoms and decreases patient distress, allowing for effective outpatient management.

Area of Science:

  • Pediatric Gastroenterology
  • Surgical Interventions for Functional Bowel Disorders

Background:

  • Pediatric constipation is a prevalent issue.
  • Antegrade continence enema (ACE) procedures alleviate daily therapy distress.
  • ACE enables more effective outpatient management of constipation.

Purpose of the Study:

  • To evaluate the impact of ACE procedures on hospital admissions for pediatric constipation.
  • To test the hypothesis that ACE procedures reduce constipation-related hospitalizations.

Main Methods:

  • Retrospective analysis of 48 pediatric patients who underwent ACE procedures (2015-2018).
  • Analysis of demographics, diagnoses, procedure types, and pre/postoperative hospital admissions.
  • Focus on appendicostomy as the primary ACE procedure.

Main Results:

  • Preoperatively, 26 patients had 63 admissions for constipation.
  • Postoperatively, only 4 patients had 5 admissions (P = .021).
  • 28 patients required non-scheduled appendicostomy tube replacement.

Conclusions:

  • ACE procedures significantly decrease hospital admissions for pediatric constipation.
  • ACE is an effective intervention for improving constipation-related symptoms in children.
  • Outpatient ACE management can lead to fewer hospitalizations.
Abstract

Keywords:
admissionappendicostomycecostomyconstipationpediatric surgery

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