Evidence map›Paper›PMID 42437421›Full record

ArticlePediatric surgery international2026

Outcomes and revision rates after antegrade continence enema (ACE) appendicostomy in a single-center LMIC paediatric cohort.

C Campilongo, E Trovalusci, L Hartford, C Bebington, C Westgarth-Taylor, Giulia Brisighelli

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Article in Pediatric surgery international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

C CampilongoPediatric Surgery Unit, Department of Women's and Children's Health, Padua University Hospital, Padua, Italy.
E TrovalusciDepartment of Pediatric Surgery, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
L HartfordDepartment of Pediatric Surgery, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
C BebingtonJohannesburg Pediatric Colorectal Clinic, Chris Hani Baragwanath Academic Hospital, Chris Hani Road, Diephloof, Soweto, Johannesburg, South Africa.
C Westgarth-TaylorPediatric Colorectal and Urogenital Program, Baylor College of Medicine, Houston, TX, USA.
Giulia BrisighelliDepartment of Pediatric Surgery, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. giuliabrisighelli@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAntegrade continence enema (ACE) appendicostomy is widely used in children with complex colorectal and neurogenic bowel conditions, yet data from resource-constrained settings remain limited. We aimed to describe the experience of a single-center pediatric cohort in a low-middle-income country (LMIC).

methodsA retrospective review of all ACE procedures performed between 2012 and 2026 was conducted. Demographics, diagnoses, indications, complications, surgeries, and functional outcomes (assessed with Milan Bowel Function Questionnaire) were collected from clinical and operative records. Descriptive statistics were applied.

resultsForty-five children (80% male) underwent ACE procedures, with a median age of 8.3 years. Most had appendicostomy; two required cecostomy intraoperatively. The most common diagnosis was anorectal malformation (n = 33, 73.3%), followed by neurogenic bowel (n = 7, 15.5%). Eight patients (17.7%) underwent a concomitant Mitrofanoff procedure. The main complication was skin-level stricture (n = 17, 37.8%), representing the only indication for surgical revision (n = 15, 33.3%), with a median time to revision of 5.5 months. Nearly all patients achieved clinical success, with high satisfaction reported on the questionnaire.

conclusionACE appendicostomy is an effective and satisfactory option in LMICs, with outcomes comparable to high-income settings, supported by careful patient selection and ongoing quality improvement efforts.

Indexed as

AppendixEnemaFecal IncontinenceNeurogenic BowelReoperationAdolescentAnorectal MalformationsChildChild, PreschoolDeveloping CountriesFemaleHumansInfantMalePostoperative ComplicationsRetrospective StudiesAnorectal malformationAntegrade continence enemasAppendicostomyLow- and middle-income countriesMaloneNeurogenic bowel

Identifiers

PMID42437421
PMCPMC13357437

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