PMID: 9639620Jun 26, 1998Paper

The Malone antegrade colonic enema procedure: outcome and lessons of 6 years' experience

Pediatric Surgery International
C P DriverA P Dickson

Abstract

The successful management of faecal incontinence can dramatically improve the quality of life of affected children. The introduction of the non-refluxing, catheterisable appendico-caecostomy provides the opportunity to treat previously resistant patients. Over a 6-year period, 29 children had a Malone antegrade continent stoma for enema administration (MACE). Incontinence was related to spina bifida in 12 children, ano-rectal anomaly in 12, Hirschprung's disease in 2, followed excision of a pelvic tumour in 2, and was secondary to intractable chronic constipation in 1. The conduit was fashioned from the appendix (20), a caecal tube (8), or a gastric tube (1). Surgical complications were stomal stenosis (11), wound infection (1), anastomotic leak (1), MACE stoma prolapse (1), and a pressure sore (1). Colonic irrigation was achieved with washouts of saline (24), saline plus phosphate (4), and saline plus Picolax (1). Twenty-three patients have complete control of bowel function, but 4 still soil. Two remain incontinent, 1 of whom is still being instructed. One child subsequently had a colostomy, but still uses the MACE stoma. Successful bowel management requires motivation, dedication, commitment, and the input of a clinical nurs...Continue Reading

Citations

Jul 7, 2009·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Sani Z YamoutMichael G Caty
Apr 17, 2007·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·D BiyaniI Maclennan
Apr 25, 2014·Gastroenterology Report·Andrew P Zbar
Apr 26, 2002·Seminars in Pediatric Surgery·A A Darakhshan, N S Williams
Feb 3, 2016·The British Journal of Surgery·D S Y Chan, R J Delicata
Jan 20, 2006·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·J L LemelleM Schmitt
Dec 22, 2009·Neurourology and Urodynamics·J J WyndaeleUNKNOWN ICI 2009 Committee 10
Oct 3, 2006·Journal of Pediatric Surgery·Seong Min KimSeung Hoon Choi
Feb 17, 2006·Journal of Pediatric Surgery·Antti KoivusaloRisto J Rintala
Dec 24, 2014·Journal of Vascular and Interventional Radiology : JVIR·Waqas Ullah KhanBairbre L Connolly
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Jan 15, 2014·The Cochrane Database of Systematic Reviews·Maureen CoggraveJune D Cody
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