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Malone appendicostomy versus cecostomy tube insertion for children with intractable constipation: A systematic review

Christine Li1, Sara Shanahan2, Michael H Livingston3

  • 1McMaster Pediatric Surgery Research Collaborative, McMaster University, Hamilton, Ontario, Canada.

Journal of Pediatric Surgery
|March 10, 2018
PubMed

Insights

Malone appendicostomy and cecostomy tube insertion offer comparable continence rates for children with severe constipation. However, Malone appendicostomy may lead to a higher need for subsequent surgeries.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Colorectal Surgery

Background:

  • Intractable constipation in children often necessitates antegrade continence enemas.
  • Treatment options include Malone appendicostomy or cecostomy tube insertion.
  • These procedures require surgical or minimally invasive techniques.

Purpose of the Study:

  • To evaluate the comparative evidence for Malone appendicostomy versus cecostomy tube insertion in pediatric patients.
  • To assess the efficacy and complication rates of these surgical interventions.

Main Methods:

  • A systematic literature search was performed across Embase, Medline, CINAHL, and Web of Science.
  • Included were comparative studies involving children treated with either Malone appendicostomy or cecostomy tube.
  • Data extraction and study screening were conducted by two independent reviewers.

Main Results:

  • Analysis of three retrospective studies (166 children) showed no significant difference in continence rates (80% vs. 70%).
  • Malone appendicostomy was associated with a higher rate of additional surgeries (30% vs. 12%, p=0.01).
  • Tube and stoma-related complications were reported, but quality of life was not assessed.

Conclusions:

  • Malone appendicostomy and cecostomy tube insertion demonstrate similar effectiveness in achieving continence.
  • Children undergoing Malone appendicostomy may face a greater likelihood of requiring further surgical intervention for complications.
Abstract

Keywords:
AppendixCecostomyChildConstipation

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