Malone antegrade continence enema
A Malone antegrade continence enema, also known as Malone procedure and by the abbreviation MACE, is a surgical procedure used to create a continent pathway proximal to the anus that facilitates fecal evacuation using enemas.
Description of procedure
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.
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, such as in spina bifida.
A percutaneous cecostomy tube 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.
Malone described it as an antegrade continence enema procedure.
- 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. 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.
- Malone procedure - surgery.med.umich.edu.