Is an antireflux procedure necessary for a successful appendicostomy? The simplified Malone antegrade continence enema procedure

• Main Authors: S J Karmarkar (Author), Achugatla Sushma (Author), A P Bangar (Author), J Krishnan (Author)
• Format: Book
• Published: Wolters Kluwer Medknow Publications, 2023-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

Aim: The aim of this study was to present the long-term institutional experience and outcomes of our Malone antegrade continence enema (MACE) procedure using the proximal appendix without any antireflux procedure. Materials and Methods: A single-center prospective study of 29 children undergoing a simplified Malone antegrade continence enema (SMACE) procedure from 2006 to 2017 was conducted using the appendix, whole or split. The mean follow-up period was 11.5 years (ranging from 5 to 16 years). Results: In 25 children, the proximal appendix was used, and in 4 cases, the whole appendix was used as a conduit. On follow-up, the MACE channel has been working well in 29/29 patients. Among the complications, seven patients had stomal stenosis, which was managed by home dilatation. There was no reflux of stools seen in any of the patients. Conclusion: The SMACE procedure, without incorporating an antireflux mechanism, is technically simpler and saves operative time. Most importantly, the results are satisfactory and comparable with procedures using antireflux techniques.

Item Description

0971-9261
1998-3891
10.4103/jiaps.jiaps_40_23