Colonic tubes for the antegrade continence enema: comparison of surgical technique

The Journal of Urology
Eric A KurzrockAnthony R Stone

Abstract

The Malone antegrade continence enema has revolutionized the management of intractable fecal incontinence and constipation. When the appendix is absent, surgical options are limited. Small series with short-term followup have demonstrated the feasibility but not the reliability of the continent colonic tube. We present our experience with a lateral based colonic tube. We also compared lateral based colonic tubes to medial based tubes. The medical records of patients treated with a continent colonic tube for intractable fecal incontinence were reviewed. We identified 8 patients who underwent the procedure between July 2000 and February 2003. The literature was reviewed to compare lateral vs medial based tubes. Average followup was 28 months (range 10 to 41). Stomal stenosis developed in 4 patients (50%) within 3 to 6 months of surgery. Passive dilation at the clinic corrected the problem in 3 patients and 1 required operative stomal revision. All 8 patients reported almost complete relief of rectal incontinence and constipation. A literature review demonstrated a significantly higher rate of stomal stenosis in lateral vs medial based colonic tubes (40% vs 12%). The continent colonic tube is a safe and effective alternative in pa...Continue Reading

References

Nov 1, 1991·The British Journal of Surgery·R A Wheeler, P S Malone
Nov 17, 1990·Lancet·P S MaloneE M Kiely
Aug 1, 1994·The British Journal of Surgery·E M KielyR A Wheeler
Dec 13, 1997·Journal of Pediatric Surgery·M A LevittA Peña
Feb 24, 1998·Journal of Pediatric Surgery·J I CurryP S Malone
Mar 14, 1998·Journal of Pediatric Surgery·D T Wilcox, E M Kiely
Jun 19, 1998·Journal of the American College of Surgeons·T W HensleD T Chang
Jul 23, 1999·Pediatric Surgery International·A C LynchP N Morreau
Jul 18, 2002·ANZ Journal of Surgery·Erica Whineray Kelly, Brendon Bowkett
Jun 11, 2003·The Journal of Urology·Antonio Macedo
Aug 13, 2003·The Journal of Urology·Eric A KurzrockJohn P Stein

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Citations

Nov 4, 2005·Pediatric Surgery International·Gregory A Surfield, David A Andrews
Jul 16, 2008·Diseases of the Colon and Rectum·J WorsøeS Laurberg
Feb 18, 2014·Journal of Pediatric Surgery·Maurizio PacilliIan Willetts
Feb 24, 2009·Gastrointestinal Endoscopy Clinics of North America·Rodrigo A Pinto, Dana R Sands
Jul 22, 2008·The Journal of Urology·Ahmad H Bani-HaniRichard C Rink
Oct 8, 2013·Journal of Pediatric Surgery·Maen M MasadehJoel Shilyansky

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