Anterograde colonic enema for faecal incontinence in adults: long-term results of 75 patients: OP14

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Aim:Construction of a permanent stoma is the ultimate solution for faecal incontinence (FI). Appendicocecostomy or ileal neoappendicostomy are alternatives which allow patients to perform anterograde colonic enemas (ACE). The aims of this study were to evaluate the success rates and longterm results of the ACEprocedures for FI in adults.Method:Patients operated on between 1999 and 2009 were retrospectively included. Clinical data were recorded as quality of life (GOQLI and SF-36 questionnaires) and incontinence scores (Wexner).Results:Seventy five patients (54 females) with a median age of 48 years (18-81) were operated on. Before surgery mean Wexner score was 14.3 (range 6-19). Late surgical complications (> 3 months) were observed in 12 patients (16%) who need re-hospitalisation (stenosis = 6; bowel obstruction = 5). After a median follow-up of 48 months (4-110), 64 patients (91%) were still performing ACE. Six had stopped because of abdominal pain or persisting faecal incontinence. Mean time for ACE was 36 min (range 15-90) and mean volume of water was 1 l. Mean Wexner score for patients using ACE was 3.4 and quality of life was good (GIQLI 113 (99-138).Conclusion:This study has confirmed the efficiency of the ACEprocedure for intractable FI with low morbidity and long-term persistent good results.

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