@article {Lopez2007, title = {{Early experience with the antegrade colonic enema stopper to reduce stomal stenosis}}, journal = {Journal of Pediatric Surgery}, volume = {42}, year = {2007}, pages = {522{\textendash}524}, abstract = {Background: Since the initial description of the antegrade colonic enema (ACE) procedure, stomal stenosis has been recognized as its most common complication. We previously reported that 44\% of our patients required a dilatation for stomal stenosis, with 22\% requiring surgical revision. We present our findings with the use of an ACE stopper (Medicina, Adlington, Lancashire, UK) as a means of avoiding this problem. Methods: A retrospective review of the case notes of all patients who underwent an ACE procedure with a follow-up longer than 6 months was carried out over a 3-year period. Two weeks after the ACE procedure, an ACE stopper was sited in the conduit for at least 4 months and removed only for catheterization. Results: Fourteen patients underwent an ACE procedure, 12 of whom received it laparoscopically. All patients received the ACE stopper. The patients{\textquoteright} median age at surgery was 10 years (range, 5-16 years). Diagnoses included spinal dysraphism (n = 6) and anorectal malformation (n = 4), with soiling as the presenting complaint among all patients. The patients{\textquoteright} median follow-up was 12 months (range, 6-39 months). There was no stomal complication, and 13 patients reported a marked improvement in soiling. Conclusions: The use of an ACE stopper has abolished stomal stenosis on short-term follow-up. We recommend the stopper as an adjunct to the overall management of concerned patients. Longer follow-up is required to establish the true effectiveness of this simple device. (c) 2007 Elsevier Inc. All rights reserved.}, issn = {0022-3468}, doi = {10.1016/j.jpedsurg.2006.10.045}, url = {http://apps.isiknowledge.com/InboundService.do?Func=Frame\&product=WOS\&action=retrieve\&SrcApp=EndNote\&Init=Yes\&SrcAuth=ResearchSoft\&mode=FullRecord\&UT=WOS:000245002900013}, author = {Pascal Jean Lopez and Ashrafian, H and Clarke, S A and Johnson, H and Kiely, E M} }