Malone antegrade continence enema
Malone antegrade continence enema | |
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Other names | MACE, Malone procedure, ACE procedure, continent appendicostomy, Malone antegrade colonic enema |
A Malone antegrade continence enema is a surgical procedure used to create a continent pathway proximal to the anus that facilitates fecal evacuation using enemas.
Description
The operation involves connecting the appendix to the abdominal wall and fashioning a valve mechanism that allows catheterization of the appendix, but avoids leakage of stool through it. If the appendix was previously removed or is unusable, a neoappendix can be created with a cecal flap.[1]
Indications
It is done to treat fecal incontinence unresponsive to treatment with medications. It is frequently done with a procedure (Mitrofanoff procedure) to treat urinary incontinence as the two often co-exist,[2] such as in spina bifida.
Cecostomy tube alternative
A percutaneous cecostomy tube (C-tube)[3] is an alternative to a MACE. It involves the surgical insertion of a catheter into the cecum for the same goal (of performing enemas). Percutaneous cecostomy procedures, like MACEs, have been performed laparoscopically.[citation needed]
Eponym
The procedure is named after the surgeon Padraig Malone who helped popularized it in the 1990s and described it with co-authors as the antegrade continence enema procedure.[4]
See also
References
- ^ Weiser AC, Stock JA, Hanna MK (June 2003). "Modified cecal flap neoappendix for the Malone antegrade continence enema procedure: a novel technique". J. Urol. 169 (6): 2321–4. doi:10.1097/01.ju.0000067286.80366.42. PMID 12771790.
- ^ Teichman JM, Rogenes VJ, Barber DB (1997). "The utility of the Malone antegrade continence enema for urologists". Tech Urol. 3 (1): 30–3. PMID 9170222.
- ^ What is a Cecostomy Catheter? cecostomy.com. URL: http://www.cecostomy.com/Introduction/cecostomy.htm Archived 2000-01-26 at the Wayback Machine. Accessed on: August 9, 2008.
- ^ Roberts JP, Moon S, Malone PS (March 1995). "Treatment of neuropathic urinary and faecal incontinence with synchronous bladder reconstruction and the antegrade continence enema procedure". Br J Urol. 75 (3): 386–9. doi:10.1111/j.1464-410X.1995.tb07354.x. PMID 7735806.