Journal of pediatric surgery · 2026
Long term outcomes of the antegrade continence enema in children with an anorectal malformation - A systematic review.
Систематический обзорСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lane Rosemary, Comella Assia, Trajanovska Misel, King Sebastian K
Аннотация
PURPOSE: The role of the antegrade continence enema (ACE) in children has been studied extensively; however, its role specifically in children with an anorectal malformation (ARM) is less clearly documented. This systematic review aimed to synthesise and evaluate existing data regarding long-term outcomes of ACE in children with ARM.
METHODOLOGY: Two databases (Embase and MEDLINE) were reviewed. Studies were eligible if their population included children under the age of 18 with an ARM who underwent an ACE procedure. All studies from when the ACE was first described in April 1990, to April 2025, were considered. We excluded conference abstracts, non-English papers and studies with less than five children with ARM in the described population.
RESULTS: After excluding duplicates, there were 456 relevant papers. Following abstract and full text screening, 19 papers were eligible for analysis. Most studies were case series, with two cross-sectional studies. The total number of children with ARM and ACE was 696. The type of ARM was specified in 205 of these patients. The type of ACE was reported for 317 patients. Although differences in continence definitions were found, continence data following the procedure were available from 16/19 studies with 404/479 patients reported to have faecal continence with ACE. There was insufficient data to subdivide the outcomes into either types of ACE or type of ARM. Complications were reported in seven studies; 128/474 patients experienced complications associated with their ACE. A total of 24 patients were reported to have ceased use of their ACE, 19 of whom no longer required it. Quality of life outcomes were commented on in four papers with overall improvement post ACE.
CONCLUSION: This systematic review highlights the lack of reporting and subgroup analysis in the published literature regarding long-term outcomes of ACE use in children with ARM. These patients differ from those with chronic idiopathic constipation, neurogenic bowel or Hirschsprung disease and, therefore, require an independent assessment of the utility of the ACE. We urge authors to consider children with ARM as a separate group when reporting outcomes of ACE use in future studies.
METHODOLOGY: Two databases (Embase and MEDLINE) were reviewed. Studies were eligible if their population included children under the age of 18 with an ARM who underwent an ACE procedure. All studies from when the ACE was first described in April 1990, to April 2025, were considered. We excluded conference abstracts, non-English papers and studies with less than five children with ARM in the described population.
RESULTS: After excluding duplicates, there were 456 relevant papers. Following abstract and full text screening, 19 papers were eligible for analysis. Most studies were case series, with two cross-sectional studies. The total number of children with ARM and ACE was 696. The type of ARM was specified in 205 of these patients. The type of ACE was reported for 317 patients. Although differences in continence definitions were found, continence data following the procedure were available from 16/19 studies with 404/479 patients reported to have faecal continence with ACE. There was insufficient data to subdivide the outcomes into either types of ACE or type of ARM. Complications were reported in seven studies; 128/474 patients experienced complications associated with their ACE. A total of 24 patients were reported to have ceased use of their ACE, 19 of whom no longer required it. Quality of life outcomes were commented on in four papers with overall improvement post ACE.
CONCLUSION: This systematic review highlights the lack of reporting and subgroup analysis in the published literature regarding long-term outcomes of ACE use in children with ARM. These patients differ from those with chronic idiopathic constipation, neurogenic bowel or Hirschsprung disease and, therefore, require an independent assessment of the utility of the ACE. We urge authors to consider children with ARM as a separate group when reporting outcomes of ACE use in future studies.