One-year outcomes for patients undergoing antegrade continence enema procedures without prior rectal enema therapy: A pediatric colorectal and pelvic learning consortium study
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Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Oct 2026 · 1 min read
In brief
In brief
Multicenter study demonstrates that upfront antegrade continence enema (ACE) procedures without prior rectal enema therapy achieve effective bowel management in children with colorectal disorders. At one-year follow-up, 90% of patients continued using ACE as primary management with low complication rates comparable to traditional stepwise approaches.
Written by the GCMD Library team from the article.
Statements in this article
Antegrade continence enemas delivered through surgically placed channels help achieve social continence in children with colorectal disorders.
High-volume centers increasingly perform ACE upfront, particularly for patients intolerant of rectal enemas.
Among 171 patients who underwent upfront ACE, the median age was 7.0 years.
Diagnoses in the upfront ACE cohort included anorectal malformation (54.4%), functional constipation (36.3%), and Hirschsprung disease (9.9%).
Approximately one-third of patients who underwent upfront ACE had an associated psychiatric or neurodevelopmental diagnosis.
71.3% of patients in the upfront ACE cohort had already failed oral laxative therapy, compared to 37.6% of the 402 patients treated with rectal enemas before ACE.
Complication rates for upfront ACE were 6.4% at 30 days and 11.1% at one year.
Complication rates for upfront ACE were comparable to those of the prior-enema cohort.
At one year, 90.0% (117/130) of patients were still using ACE flushes as their primary bowel management.
At one year, 6.4% (11/171) of patients had discontinued ACE flushes, none because of an inability to manage constipation or incontinence.