CONTROL OF FECAL INCONTINENCE - CONTINUED SUCCESS WITH THE MALONE PROCEDURE

Background. Ocr center has previously reported the use of the Malone a ntegrade continence enema procedure in children. The procedure involve s bringing the appendix to the surface of the abdominal wall to provid e a nonrefluxing catheterizable channel that enables antegrade colonic lavage for the control of fecal incontinence. Methods. This report cr itically evaluates 23 patients treated for fecal incontinence with up to 6 years of follow-up. After operation, specific scoring criteria we re used for assessment. Success in surgical technique, control of feca l soiling, and improvement in quality of life were evaluated. Results. More than 85% of patients achieved maximal or near-maximal scores in all three categories. Postoperative complications remain a relevant co ncern when this procedure is undertaken, but We have found that signif icant postoperative complications are few and can be minimized by meti culous follow-up. Conclusions. Overall, the Malone antegrade continenc e enema procedure has been shown to be safe and highly effective. Ther e is the potential for wider application in older age groups where sph incter and pelvic floor muscles have been compromised as a result of t rauma or cancer surgery.