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The Malone antegrade colonic enema procedure: outcome and lessons of 6 years' experience
- Source :
- Pediatric Surgery International. 13:370-372
- Publication Year :
- 1998
- Publisher :
- Springer Science and Business Media LLC, 1998.
-
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 nurse specialist. The MACE is a relatively straightforward operative procedure that provides an effective washout technique that is acceptable to both parents and children.
- Subjects :
- Male
medicine.medical_specialty
Adolescent
Colon
medicine.medical_treatment
Bowel management
Enema
Anastomosis
Stoma
Postoperative Complications
Recurrence
Pediatric surgery
Humans
Medicine
Child
Retrospective Studies
Chronic constipation
business.industry
Colostomy
General Medicine
digestive system diseases
Surgery
Cecostomy
Treatment Outcome
Child, Preschool
Chronic Disease
Pediatrics, Perinatology and Child Health
Female
business
Constipation
Fecal Incontinence
Mace
Follow-Up Studies
Subjects
Details
- ISSN :
- 14379813 and 01790358
- Volume :
- 13
- Database :
- OpenAIRE
- Journal :
- Pediatric Surgery International
- Accession number :
- edsair.doi.dedup.....5c6e1b122977b878c538ef111127e72a