Antegrade continence enema - An analysis of 20 children with faecal incontinence

Abstract

Aim of the Study: We present our experience with the Malone antegrade continence enema technique in children suffering from severe anal incontinence. Methods: The Malone antegrade continence enema technique was performed using the appendix, caecum or ileum in 20 children with faecal incontinence. The stoma was kept catheterised for three weeks after the operation in all patients and irrigation with saline was initiated after that period. Tap water was used for irrigations after discharge from hospital. The functional success was evaluated according to the classification defined by Curry et al. Results: The mean age and the mean follow-up period was 11 years and 5 years, respectively. Strictures developed in five of the 20 cases (25%) in this series. Four of these patients underwent revisional surgery, but in one case with appendiceal tube the stricture and catheterisation difficulty resolved spontaneously. Full continence was achieved in 13 of the children (65%). Conclusions: The Malone procedure is an effective procedure in children with faecal incontinence. It should be performed after confirming that the patient is completely clean using Pena's programme and aften ensuring that both the child and the parents will properly follow the recommendations.