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Antegrade continence enema--an analysis of 20 children with faecal incontinence

Y Soylet1, E Yesildag, C Besik

  • 1Department of Paediatric Surgery, Istanbul University, Cerrahpasa Medical Faculty, Istanbul, Turkey. ysoylet@superonline.com

European Journal of Pediatric Surgery : Official Journal of Austrian Association of Pediatric Surgery ... [Et Al] = Zeitschrift Fur Kinderchirurgie
|September 19, 2006
PubMed

Insights

The Malone antegrade continence enema (MACE) procedure effectively treats severe fecal incontinence in children. This surgical technique achieved full continence in 65% of patients, demonstrating its value in pediatric care.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Urology

Background:

  • Severe anal incontinence significantly impacts children's quality of life.
  • The Malone antegrade continence enema (MACE) technique offers a surgical solution for managing fecal incontinence.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of the MACE procedure in children with severe fecal incontinence.

Main Methods:

  • The MACE procedure was performed on 20 children using various intestinal segments (appendix, cecum, or ileum).
  • Post-operative management included a three-week catheterization period followed by saline irrigations, transitioning to tap water at home.
  • Functional success was assessed using the Curry et al. classification system.

Main Results:

  • The study included 20 children with a mean age of 11 years and a mean follow-up of 5 years.
  • Strictures occurred in 25% of cases (5/20), with four requiring revision; one appendiceal stricture resolved spontaneously.
  • Overall, 65% (13/20) of the children achieved full continence.

Conclusions:

  • The Malone antegrade continence enema procedure is an effective treatment for pediatric fecal incontinence.
  • Successful outcomes depend on pre-operative bowel cleansing (Peña's program) and adherence to post-operative care by patients and parents.
Abstract

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