The antegrade continence enema procedure why, when and how?

Malone, P.S.; Curry, Joseph I.; Osborne, Alan W.

doi:10.1007/s003450050066

Cited by 64 publications

(36 citation statements)

References 11 publications

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“…In this study, the primary and secondary technical success rates of insertion of cecostomy tubes were 95% and 100%, respectively, which are similar to other studies [8][9][10][11]14,15,17] . Long term follow up of patients showed resolution of continuous soiling in all patients with neurogenic fecal incontinence.…”

Section: Discussionsupporting

confidence: 90%

“…This study was later followed by other studies that showed this percutaneous procedure represents a less invasive alternative to a surgical procedure [8][9][10][11][12] . Percutaneous endoscopic cecostomy is a viable alternative to surgically or fluoroscopically placed cecostomy in a select group of patients with recurrent colonic pseudo-obstruction or chronic intractable constipation [13] .…”

Section: Introductionmentioning

confidence: 81%

“…On the other hand, patients with organic fecal incontinence benefit from techniques that teach them how to defecate, such as with cecostomy, which completely cleanses the colon, increases the child's autonomy, and decreases the chance of soiling. However, there is great variation in the postsurgical functional outcomes of these procedures [3,[8][9][10][11][12] . The purpose of our study was to assess the effectiveness and safety of imaging-guided percutaneous cecostomy in the management of pediatric patients with organic fecal incontinence.…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous cecostomy in the management of organic fecal incontinence in children

Donkol

Al-Nammi²

2010

WJR

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AIM:To assess the effectiveness and safety of imagingguided percutaneous cecostomy in the management of pediatric patients with organic fecal incontinence. METHODS:Twenty three cecostomies were performed on 21 children with organic fecal incontinence (13 males, 8 females), aged from 5 to 16 years (mean 9.5 years). Thirteen patients had neurogenic fecal incontinence and 8 patients had anorectal anomalies. Procedures were performed under general anesthesia and fluoroscopic guidance. Effectiveness and complication data were obtained for at least 1 year after the procedure. RESULTS:Cecostomy was successful in 20 patients (primary technical success rate 95%). Cecostomy failed in one patient due to tube breakage (secondary technical success rate 100%). The tubes were in situ for an average of 18 mo (range 12-23 mo). Eighteen patients (87%) expressed satisfaction with the procedures. Resolution of soiling was achieved in all patients with neurogenic fecal incontinence (100%) and in 5 of 8 patients with anorectal anomalies (62.5%). Eleven patients (52%) experienced minor problems. No major complications were noted. CONCLUSION:Percutaneous cecostomy improves the quality of life in children with organic fecal incontinence. A satisfactory outcome is more prevalent in patients with neurogenic fecal incontinence than anorectal anomalies.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 81%

Section: Introductionmentioning

confidence: 99%

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Percutaneous cecostomy in the management of organic fecal incontinence in children

Donkol

Al-Nammi²

2010

WJR

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“…9 Since Malone and colleagues presented a preliminary report of an antegrade colonic enema (Malone antegrade continence enema [MACE]) procedure in 1990, 10 it has gained wide acceptance by urologists as a successful treatment for intractable neuropathic bowel dysfunction. [11][12][13][14][15][16] However, the MACE procedure is an invasive operation with a relatively high incidence of complications. [12][13][14][15][16] In recent years, transanal irrigation (TAI) has become a popular option in the management of NBD due to its successful results and acceptable safety profile.…”

Section: Introductionmentioning

confidence: 99%

Peristeen anal irrigation as a substitute for the MACE procedure in children who are in need of reconstructive bladder surgery

Alenezi¹,

Alhazmi²,

Trbay³

et al. 2014

CUAJ

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Cite as: Can Urol Assoc J 2014;8(1-2):e12-5. http://dx.doi.org/10.5489/cuaj.1263 Published online January 14, 2014. AbstractIntroduction: We evaluate the efficacy of the Peristeen (Coloplast A/S, Kokkedal, Denmark) transanal irrigation (TAI) system, as a stool cleansing mechanism, to gain stool continence in children who need reconstructive bladder surgery and have fecal incontinence. Methods: We prospectively evaluated children with neuropathic bladder and bowel dysfunction who were intended for reconstructive bladder surgery and the Malone antegrade continence enema (MACE) procedure. All patients were started on the Peristeen TAI system at least 3 months before surgery to assess their response. Each patient's bowel function, frequency of using the system, satisfaction (and that of their parents) and diaper independency were evaluated before and after reconstructive surgery. Results: We included 18 patients (11 female, 7 male) who were evaluated from April 2006 to the present. The mean age of the group was 7.6 years (range: 4-15). Fifteen patients (83.3%) showed complete dryness from stools. Of the 15 patients, 8 (53.3%) were able to be diaper-free, while 6 continued wearing diapers due to fear of soiling and 1 due to urinary incontinence. The patients underwent reconstructive bladder surgery and continued to use the Peristeen TAI system with the same results postoperatively. The main limitation of this study is the small number of patients included, although this is a very specific patient group. Conclusion: Our initial results suggest that the Peristeen TAI system is a successful conservative substitute for the MACE procedure in children who require reconstructive bladder surgery.

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“…It is usually developed based on an individual trial and error basis for each of the patients 1 . The solutions, their volumes and intervals between washouts are tested and modified whenever necessary in a process which usually takes, approximately, a month after operation, but which can take up to six months 3 . Metabolic iatrogenic complications of enema administration in children are not rare, but most of them are self-limited and have no clinical manifestations.…”

Section: Introductionmentioning

confidence: 99%

Experimental antegrade enema: effects on water, electrolyte and acid-base balances with different solutions

et al. 2007

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PURPOSE: To study the effects on the water, electrolyte, and acid-base balances in rabbits submitted to antegrade enema with different solutions through appendicostomy. METHODS: Forty male New Zealand rabbits were submitted to appendicostomy, and distributed in 4 groups, according to the antegrade enema solution: PEG group, polyethylene glycol electrolyte solution (n=10); ISS group, isotonic saline solution (n=10); GS group, glycerin solution (n=10); SPS group, sodium phosphate solution (n=10). After being weighed, arterial blood gas analysis, red blood count, creatinine and electrolytes were measured at 4 times: preoperatively (T1); day 6 postop, before enema (T2); 4h after enema (T3); and 24h after T3 (T4). RESULTS: In PEG group occurred Na retention after 4h, causing alkalemia, sustained for 24h with HCO3 retention. In ISS group occurred isotonic water retention and hyperchloremic acidosis after 4h, which was partially compensated in 24h. GS group showed metabolic acidosis after 4h, compensated in 24h. In SPS group occurred hypernatremic dehydration, metabolic acidosis in 4h, and hypokalemia, hypocalcemia, hypomagnesemia, and metabolic alkalosis with partially compensated dehydration in 24h. CONCLUSIONS: All solutions used in this study caused minor alterations on water, electrolyte or acid-base balances. The most intense ones were caused by hypertonic sodium phosphate solution (SPS) and isotonic saline solution (ISS) and the least by polyethyleneglycol electrolyte solution (PEG) and glycerin solution 12% (GS).

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The antegrade continence enema procedure why, when and how?

Cited by 64 publications

References 11 publications

Percutaneous cecostomy in the management of organic fecal incontinence in children

Percutaneous cecostomy in the management of organic fecal incontinence in children

Peristeen anal irrigation as a substitute for the MACE procedure in children who are in need of reconstructive bladder surgery

Experimental antegrade enema: effects on water, electrolyte and acid-base balances with different solutions

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