IN SITU MALONE ANTEGRADE CONTINENCE ENEMA IN 127 PATIENTS: A 6-YEAR EXPERIENCE
2004; Lippincott Williams & Wilkins; Volume: 172; Issue: 4 Part 2 Linguagem: Inglês
10.1097/01.ju.0000138528.55602.20
ISSN1527-3792
AutoresC.D. Anthony Herndon, Richard C. Rink, Mark P. Cain, Michelle A. Lerner, Martin Kaefer, Elizabeth B. Yerkes, Anthony J. Casale,
Tópico(s)Pelvic floor disorders treatments
ResumoNo AccessJournal of UrologyNeurogenic Bladder1 Oct 2004IN SITU MALONE ANTEGRADE CONTINENCE ENEMA IN 127 PATIENTS: A 6-YEAR EXPERIENCE C.D. ANTHONY HERNDON, RICHARD C. RINK, MARK P. CAIN, MICHELLE LERNER, MARTIN KAEFER, ELIZABETH YERKES, and ANTHONY J. CASALE C.D. ANTHONY HERNDONC.D. ANTHONY HERNDON , RICHARD C. RINKRICHARD C. RINK , MARK P. CAINMARK P. CAIN , MICHELLE LERNERMICHELLE LERNER , MARTIN KAEFERMARTIN KAEFER , ELIZABETH YERKESELIZABETH YERKES , and ANTHONY J. CASALEANTHONY J. CASALE View All Author Informationhttps://doi.org/10.1097/01.ju.0000138528.55602.20AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: 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. Materials and Methods: 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. Results: 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 volvulus requiring a right hemicolectomy in 1 patient, small bowel obstruction in 2, and shunt infection and/or malfunction in 2. Four patients have elected to no longer use the MACE for non-technical reasons. Conclusions: The in situ MACE procedure has reliable long-term results for treating fecal incontinence associated with neuropathic bowel. References 1 : Preliminary report: the antegrade continence enema. Lancet1990; 336: 1217. Google Scholar 2 : The clinical application of the Malone antegrade colonic enema. J Pediatr Surg1993; 28: 1012. Google Scholar 3 : The Malone antegrade continence enema for neurogenic and structural fecal incontinence and constipation. J Urol1995; 154: 759. Link, Google Scholar 4 : Antegrade enemas for the treatment of severe idiopathic constipation. Br J Surg1994; 81: 1490. Google Scholar 5 : The antegrade continence enema. J Pediatr Surg1995; 30: 68. Google Scholar 6 : Treatment of neuropathic urinary and faecal incontinence with synchronous bladder reconstruction and the antegrade continence enema procedure. Br J Urol1995; 75: 386. Google Scholar 7 : The Malone antegrade colonic enema enhances the quality of life in children undergoing urological incontinence procedures. J Urol1996; 155: 1416. Link, Google Scholar 8 : In situ imbricated appendix: experience with simple MACE technique. J Urol1999; 161: 589. Google Scholar 9 : The Malone (antegrade continence enema) procedure: early experience. J Pediatr Surg1998; 33: 204. Google Scholar 10 : Continent appendicostomy in the bowel management of fecally incontinent children. J Pediatr Surg1997; 32: 1630. Google Scholar 11 : Combined Mitrofanoff and antegrade continence enema procedures for urinary and fecal incontinence. J Urol1997; 158: 192. Link, Google Scholar 12 : Role of the antegrade continence enema in the management of the most debilitating childhood rectourogenital malformations. J Urol1997; 158: 1277. Link, Google Scholar 13 : The antegrade continence enema procedure: a review of the literature. J Pediatr Surg1998; 33: 1294. Google Scholar 14 : The in situ appendix in the Malone antegrade continence enema procedure for faecal incontinence. Br J Urol1997; 79: 985. Google Scholar 15 : The Malone antegrade continence enema procedure in the management of patients with spina bifida. J Am Coll Surg1998; 186: 669. Google Scholar 16 : The MACE procedure: experience in the United Kingdom. J Pediatr Surg1999; 34: 338. Google Scholar 17 : Y-appendicoplasty: a technique to minimize stomal complications in antegrade continence enema. J Pediatr Surg1999; 34: 1733. Google Scholar 18 : Laparoscopic antegrade continence enema in situ appendix procedure for refractory constipation and overflow fecal incontinence in children with spina bifida. J Urol2000; 164: 1084. Link, Google Scholar 19 : Factors that influence outcomes of the Mitrofanoff and Malone antegrade continence enema reconstructive procedures in children. J Urol2002; 168: 1537. Link, Google Scholar 20 : The Malone antegrade continence enema procedure: quality of life and family perspective. J Urol2003; 169: 320. Link, Google Scholar © 2004 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited ByChu D, Balsara Z, Routh J, Ross S and Wiener J (2018) Experience with Glycerin for Antegrade Continence Enema in Patients with Neurogenic BowelJournal of Urology, VOL. 189, NO. 2, (690-693), Online publication date: 1-Feb-2013.Hoy N, Metcalfe P and Kiddoo D (2018) Outcomes Following Fecal Continence Procedures in Patients with Neurogenic Bowel DysfunctionJournal of Urology, VOL. 189, NO. 6, (2293-2297), Online publication date: 1-Jun-2013.Ellison J, Haraway A and Park J (2013) The Distal Left Malone Antegrade Continence Enema—Is it Better?Journal of Urology, VOL. 190, NO. 4S, (1529-1534), Online publication date: 1-Oct-2013.Nanigian D and Kurzrock E (2018) Intermediate-Term Outcome of the Simplified Laparoscopic Antegrade Continence Enema Procedure: Less is BetterJournal of Urology, VOL. 179, NO. 1, (299-303), Online publication date: 1-Jan-2008.Nanigian D, Nguyen T, Tanaka S, Cambio A, DiGrande A and Kurzrock E (2008) Development and Validation of the Fecal Incontinence and Constipation Quality of Life Measure in Children With Spina BifidaJournal of Urology, VOL. 180, NO. 4S, (1770-1773), Online publication date: 1-Oct-2008.Bani-Hani A, Cain M, King S and Rink R (2008) Tap Water Irrigation and Additives to Optimize Success With the Malone Antegrade Continence Enema: The Indiana University AlgorithmJournal of Urology, VOL. 180, NO. 4S, (1757-1760), Online publication date: 1-Oct-2008.Bani-Hani A, Cain M, Kaefer M, Meldrum K, King S, Johnson C and Rink R (2018) The Malone Antegrade Continence Enema: Single Institutional ReviewJournal of Urology, VOL. 180, NO. 3, (1106-1110), Online publication date: 1-Sep-2008.HERNDON C, CAIN M, CASALE A and RINK R (2018) THE COLON FLAP/EXTENSION MALONE ANTEGRADE CONTINENCE ENEMA: AN ALTERNATIVE TO THE MONTI-MALONE ANTEGRADE CONTINENCE ENEMAJournal of Urology, VOL. 174, NO. 1, (299-302), Online publication date: 1-Jul-2005.SOYGUR T, ARIKAN N, ZUMRUTBAS A and GULPINAR O (2018) SEROSAL LINED EXTRAMURAL TUNNEL (GHONEIM) PRINCIPLE IN THE CREATION OF A CATHETERIZABLE CHANNEL IN BLADDER AUGMENTATIONJournal of Urology, VOL. 174, NO. 2, (696-699), Online publication date: 1-Aug-2005.DeFOOR W, MINEVICH E, REDDY P, BARQAWI A, KITCHENS D, SHELDON C and KOYLE M (2018) PERFORATION OF MALONE ANTEGRADE CONTINENCE ENEMA: DIAGNOSIS AND MANAGEMENTJournal of Urology, VOL. 174, NO. 4 Part 2, (1644-1646), Online publication date: 1-Oct-2005. Volume 172Issue 4 Part 2October 2004Page: 1689-1691 Advertisement Copyright & Permissions© 2004 by American Urological Association, Inc.Keywordsenemaconstipationfecal incontinenceMetricsAuthor Information C.D. ANTHONY HERNDON More articles by this author RICHARD C. RINK More articles by this author MARK P. CAIN More articles by this author MICHELLE LERNER More articles by this author MARTIN KAEFER More articles by this author ELIZABETH YERKES More articles by this author ANTHONY J. CASALE More articles by this author Expand All Advertisement PDF DownloadLoading ...
Referência(s)