Related Experiment Video
Updated: Sep 27, 2025
Studying Brain Function in Children Using Magnetoencephalography
Published on: April 8, 2019
Transition and reversal: long-term experience of the MACE procedure in children
Riyad Peeraully1, Jason Langley2, Nicola Hayes2
1Queen's Medical Centre, Nottingham, NG7 2UH, UK. riyad77@gmail.com.
Insights
The Malone antegrade continence enema (MACE) procedure shows a 72% success rate in children. Some patients achieve continence and undergo MACE reversal, highlighting the need for smooth transition to adult care.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Urology
Background:
- The Malone antegrade continence enema (MACE) procedure is utilized for fecal incontinence in children.
- Understanding long-term outcomes and follow-up is crucial for optimizing patient care.
Purpose of the Study:
- To analyze the outcomes and follow-up of pediatric patients who underwent the MACE procedure.
- To evaluate the success rates and identify factors influencing outcomes in different pediatric conditions.
Main Methods:
- Retrospective analysis of 95 children undergoing MACE from 1998-2020.
- Data collection included demographics, clinical details, and categorized outcomes (success, partial, failure).
Main Results:
- Overall success rate was 72%. Success rates varied by diagnosis: 69% for chronic idiopathic constipation (CIC), 78% for anorectal malformations (ARM), and 69% for Hirschsprung's disease (HD).
- 21% of patients underwent MACE reversal after achieving continence, with significant differences between groups (HD highest at 54%).
- 50% of patients over 16 years old were transitioned to adult services.
Conclusions:
- The MACE procedure demonstrates a high success rate in pediatric patients.
- A significant proportion of patients achieve continence and may no longer require the MACE, necessitating careful consideration for reversal.
- Transitioning adolescent patients requiring ongoing support to adult services is essential for continuity of care.
Purpose:
Analysis of outcomes and follow-up of children who underwent the Malone antegrade continence enema (MACE) procedure in a UK tertiary paediatric surgery unit.
Methods:
Children who underwent a MACE procedure from 1998 to 2020 were identified. Demographic and clinical data were obtained from contemporaneous records. Outcomes were categorised as full (success), partial or failure.
Results:
Ninety-five children were identified for inclusion (chronic idiopathic constipation (CIC, 59), anorectal malformations (ARM, 23) and Hirschsprung's disease (HD, 13)). Mean age at surgery was 9.4 years (3-19 years) and mean follow-up time was 6 years (0.3-16.8 years). Outcomes were successful in 69% of CIC patients, 78% in ARM and 69% in HD. Twenty (21%) underwent MACE reversal after developing independent continence, with a significant difference between groups (CIC 19%, ARM 9%, HD 54%, p = 0.0047). 50% of patients > 16 years old were transitioned to adult services.
Conclusion:
We report a success rate of 72% for MACE procedures in our unit, with a significant difference in reversal rate between diagnostic groups. Long term, a fifth of patients no longer required their MACE. When these patients reach adolescence, those who require ongoing support outside of the paediatric surgery setting should be safely transitioned to adult services.
