The Malone antegrade continence enema now commonly known as the ACE procedure was described originally for the treatment of intractable fecal incontinence in 1990. Since this time it has been used widely in many centers for the treatment of constipation and faecal soiling in both adult and pediatric practice. This case report describes a previously unreported complication of an ACE that developed in a disused appendicocecostomy in a child.
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Single Incision Laparoscopic Surgery for Malone Antegrade Continent Enema: Optimizing Outcomes in Pediatric Bowel Management.
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November 2024
Comprehensive Colorectal Center, Department of Surgery, Children's Mercy Kansas City, Kansas City, MO, USA; Department of Surgery, University of Missouri-Kansas City, Kansas City, MO 64108, USA. Electronic address:
Background: Malone antegrade continence enemas (MACE) are increasingly being used to manage severe constipation and fecal incontinence in children. Despite advances in minimally invasive pediatric colorectal surgery, single-incision laparoscopic surgery (SILS) for MACE creation remains relatively unexplored. This study, featuring the largest cohort to date, evaluates the feasibility, safety, and clinical outcomes of SILS MACE creation in children.
View Article and Find Full Text PDFAre buccal mucosal grafts useful for continent catheterizable channel stenosis? A French' reconstructive urology centers experience.
Fr J Urol
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Service d'urologie, CHU de Grenoble, 38700 La Tronche, France; Service d'urologie, hôpital Foch, 92150 Suresnes, France.
Introduction: Cutaneous stoma stenosis represents a frequent complication associated with continent catheterizable channel, often necessitating recurrent patients' consultation, hospital admission, and repetitive surgical interventions. Management strategies encompass dilatation, incision, and, in case of refractory stenosis, invasive surgical revision.
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Medical Alert Cards for Pediatric Patients With Antegrade Continence Enemas to Enhance Awareness.
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Comprehensive Colorectal Center, Department of Surgery, Children's Mercy Kansas City, Kansas City, Missouri; Department of Surgery, University of Missouri-Kansas City, Kansas City, Missouri. Electronic address:
Introduction: The antegrade continence enema (ACE) is a surgical technique that establishes a route for colonic irrigation, necessitating a detailed comprehension of the procedural methodology, including the conduit construction, the catheters selection, and the administration of irrigation solutions. It is critical to disseminate comprehensive information regarding ACE procedures to health-care professionals and caregivers to enhance their understanding and support management of patients undergoing this intervention. This study aims to evaluate the efficacy of a novel educational tool designed to augment the knowledge base of physicians and caregivers regarding ACE procedures.
View Article and Find Full Text PDFWhat Happens Post-Malone? An Investigation of Long-Term Postoperative Management of Antegrade Continence Enemas.
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Department of Pediatric Surgery, Akron Children's Hospital, Akron, OH, USA. Electronic address:
Article Synopsis
- The study examines the use of antegrade continence enemas (ACE) in children with medically refractory fecal incontinence and constipation, focusing on patient perceptions and the potential to discontinue the use of the associated appendicostomy/cecostomy tube.
- Data was gathered from 165 patients who underwent ACE procedures between 2012 and 2021, with 82 completing a follow-up survey revealing satisfaction rates and reasons for discontinuing flushes.
- Findings indicate a high satisfaction rate (76.8% very satisfied), with 21.8% of patients able to stop using flushes for various reasons, and a strong recommendation rate for ACE among respondents.
Malone Antegrade Continence Enema Procedure in the Management of Chronic Constipation.
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Elson S. Floyd College of Medicine, WSU, Spokane, Washington Kadlec Regional Medical Center.
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