In situ Malone antegrade continence enema in 127 patients: a 6-year experience

The Journal of Urology
C D Anthony HerndonAnthony J Casale

Abstract

The initial description of the Malone antegrade continence enema (MACE) relied on a reversed, tunneled and reimplanted appendix. In 1999 we reported our in situ technique that uses windows developed in the appendiceal mesentery for imbrication. We present our long-term results. From 1997 to 2003, 168 patients were identified who had undergone a MACE procedure. An in situ technique was performed in 76 females and 51 males. Average patient age at the time of surgery was 9.6 years (range 2.9 to 28.4). Diagnoses included myelomeningocele in 116 cases, lipomeningocele in 6, spinal cord injury in 2, posterior urethral valves in 1, sacral agenesis in 1 and functional constipation in 1. Cecal plication/imbrication was performed in 100 patients, appendix intussusception and imbrication in 24, and creation of tenia flaps in 3. The abdominal stoma was umbilical in 50 cases, right lower quadrant in 74 and periumbilical in 3. Concomitant genitourinary reconstruction was performed in 87% of patients. Mean followup was 26.9 months (range 0.7 to 68.1). Fecal continence was reported by 91% of the patients. Thirteen stomal revisions (stenosis 10, prolapse 2 and leakage 1) were required in 11 patients. Major complications included a cecal volvulu...Continue Reading

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Citations

Jan 10, 2008·Pediatric Surgery International·Alan P DicksonRaimondo M Cervellione
Sep 18, 2007·Diseases of the Colon and Rectum·Jane J Y TanJoe J Tjandra
Jul 16, 2008·Diseases of the Colon and Rectum·J WorsøeS Laurberg
Jan 11, 2014·World Journal of Gastroenterology : WJG·Julie Ann M Van Koughnett, Steven D Wexner
Jan 21, 2014·Journal of Pediatric Urology·Philip CorbettMichael P Stanton
Dec 7, 2014·Physical Medicine and Rehabilitation Clinics of North America·Aaron Powell, Loren Davidson
Feb 5, 2013·The Journal of Urology·Jonathan S EllisonJohn M Park
Dec 29, 2012·The Journal of Urology·Nathan Y HoyDarcie A Kiddoo
Oct 23, 2012·Journal of Pediatric Surgery·Hye Kyung ChangJung-Tak Oh
Sep 19, 2012·The Journal of Urology·David I ChuJohn S Wiener
Apr 30, 2011·Journal of Pediatric Urology·Joon-ha Ok, Eric A Kurzrock
Feb 12, 2011·Journal of Pediatric Urology·S C BlackburnM Haddad
Mar 20, 2010·Gastroentérologie Clinique Et Biologique·G MeuretteN Regenet
Sep 29, 2009·Seminars in Pediatric Surgery·Cheryl E Gariepy, Hayat Mousa
Jul 22, 2008·The Journal of Urology·Ahmad H Bani-HaniRichard C Rink
Dec 22, 2009·Neurourology and Urodynamics·J J WyndaeleUNKNOWN ICI 2009 Committee 10
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Mar 2, 2017·Pediatric Radiology·Megan B MarineBoaz Karmazyn
Jul 12, 2007·Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie·J M SolerE Chartier-Kastler

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