Malone antegrade continence enema

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The vermiform appendix is typically used in the 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[edit]

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[edit]

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.

Surgical alternative[edit]

A percutaneous cecostomy 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.

Eponym[edit]

It is named after the surgeon (Patrick Malone) who popularized it.[4]

Malone described it as an antegrade continence enema procedure.[4]

See also[edit]

References[edit]

  1. ^ 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. 
  2. ^ 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. 
  3. ^ What is a Cecostomy Catheter? cecostomy.com. URL: http://www.cecostomy.com/Introduction/cecostomy.htm. Accessed on: August 9, 2008.
  4. ^ a b 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. 

External links[edit]