Purpose: Antegrade continence enemas (ACE) are an efficacious therapeutic option for patients with fecal incontinence. The authors review their institution's experience with a variation of the Monti-Malone ACE procedure using the left colon as a source of an intestinal conduit and enema reservoir.
Methods: From 2000 to 2002, 18 patients with fecal incontinence or intractable constipation underwent left-colon ACE (LACE) procedure. Concomitant Mitrofanoff appendicovesicostomy was performed in 15 patients and bladder augmentation in 9. The majority of patients had neural tube defects. A segment of left colon was tubularized, tunneled into the muscular wall of the distal colon, and exteriorized through the left upper quadrant or midabdomen. Stomal catherization and enema installation were started one month postoperatively.
Results: Fifteen patients (83%) achieved fecal continence, 2 remain incontinent of stool, and 1 experienced stomal closure (mean follow-up was 24 +/- 9 months). Two patients had stomal stenosis that required revision. The mean enema volume in patient's achieving continence was 360 +/- 216 mL, and the mean transit time was 18 +/- 12 minutes.
Conclusions: LACE is an efficacious procedure for fecal incontinence that can be performed safely at the time of major urologic reconstruction. Administration of enemas into the left colon has several physiologic advantages that result in predictable bowel evacuation.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jpedsurg.2003.08.051 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Fatigue, pain and faecal incontinence in adult inflammatory bowel disease patients and the unmet need: a national cross-sectional survey.
BMC Gastroenterol
December 2024
Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, 57 Waterloo Road, London, London, SE1 8WA, UK.
Background And Aims: The co-existence of fatigue, pain and faecal incontinence in people with Inflammatory Bowel Disease (IBD) is unknown. We aimed to determine the presence of and relationship between these symptoms and patients' desire for intervention.
Methods: Adults with IBD in the UK, recruited from clinics, the national IBD-BioResource, a patient charity and social media sources, completed PROMIS validated patient-reported questionnaires to identify fatigue, pain and faecal incontinence, in addition to symptom severity and impact, disease activity, anxiety and depression questionnaires and questions about their desire for help with these symptoms.
Exosomes derived from umbilical cord mesenchymal stem cells promote healing of complex perianal fistulas in rats.
Stem Cell Res Ther
December 2024
National Colorectal Disease CenterNanjing Hospital of Chinese Medicine, Affiliated to Nanjing University of Chinese Medicine, Nanjing, 210022, Jiangsu, People's Republic of China.
Background: Complex perianal fistulas, challenging to treat and prone to recurrence, often require surgical intervention that may cause fecal incontinence and lower quality of life due to large surgical wounds and potential sphincter damage. Human umbilical cord-derived MSCs (hUC-MSCs) and their exosomes (hUCMSCs-Exo) may promote wound healing.
Methods: This study assessed the efficacy, mechanisms, and safety of these exosomes in treating complex perianal fistulas in SD rats.
PREVENTion and treatment of incontinence-associated dermatitis through a codesigned manual (PREVENT-IAD): a study protocol for a feasibility cluster randomised controlled trial with a nested process evaluation.
BMJ Open
December 2024
School of Health Sciences, University of Southampton, Southampton, Hampshire, UK.
Introduction: Incontinence is commonly experienced by adults who receive care support in a residential facility or in their own home. These individuals are at risk of developing incontinence-associated dermatitis (IAD), which is caused by prolonged and repeated exposure of the skin to urine or faeces. An IAD manual was developed providing an evidence-based clinical algorithm and an e-learning training programme for the prevention and treatment of IAD.
View Article and Find Full Text PDFEpisiotomy and innervation zones of the external anal Sphincter: A case series investigating the impact on neurological patterns.
J Electromyogr Kinesiol
December 2024
Department of Obstetrical and Gynecological Pathology, Division of General Surgery and Medical Surgical Specialities, University of Catania, Catania, Italy. Electronic address:
Objective: To investigate the impact of mediolateral episiotomy on the innervation zones of the External Anal Sphincter (EAS) in the absence and presence of direct muscular injury.
Methods: This case series examined four primiparous women, including three who underwent vaginal deliveries with mediolateral episiotomy and one cesarean section case for reference. Pre- and post-delivery assessments utilized surface electromyography (sEMG) and endoanal ultrasound to evaluate changes in the EAS's innervation zones and obstetrical EAS injuries, alongside the Wexner score for fecal incontinence.
Biofeedback Therapy in Managing Functional Fecal Incontinence in Children: A Literature Review.
Cureus
November 2024
Physical Medicine and Rehabilitation, Centro Hospitalar Universitário de Santo António, Porto, PRT.
This literature review explores the role of biofeedback therapy (BFT) in managing functional fecal incontinence (FFI) in children - a common condition with a substantial impact on the quality of life. FFI diagnosis relies primarily on medical history and thorough physical examination and is categorized by the Rome IV criteria into functional constipation (FC) and functional nonretentive fecal incontinence (FNRFI). Treatment options for FFI remain limited, particularly for FNRFI.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!