Psychosocial factors impacting antegrade continence enema outcomes in pediatric patients

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Child Psychology

Background:

• Constipation and encopresis in children often require medication and behavioral therapies.
• Antegrade continence enema (ACE) procedures are surgical options for persistent constipation.
• While many children benefit from ACE, some experience ongoing incontinence, complications, or stoma issues.

Purpose of the Study:

• To review existing research on psychosocial factors influencing ACE treatment outcomes and complications.
• To identify knowledge gaps and support future research for developing pre-procedure evaluation guidelines.
• To inform ACE candidacy and interventions for high-risk children.

Main Methods:

• Literature review of studies examining psychosocial factors and ACE outcomes.
• Analysis of identified factors such as age, psychiatric symptoms, and adherence.
• Synthesis of current evidence and limitations in research.

Main Results:

• Psychosocial factors are implicated in ACE treatment success and complications.
• Limited research currently exists on the specific impact of these factors.
• Age, psychiatric symptoms, and adherence to the ACE regimen are noted as potential influences.

Conclusions:

• Standardized biopsychosocial guidelines for ACE candidacy are currently lacking.
• Pre-procedure psychosocial evaluations could enhance patient selection and post-operative care.
• Further investigation is crucial to establish evidence-based guidelines for optimizing ACE outcomes.