Malone antegrade colonic irrigation: ileal neoappendicostomy is the preferred procedure in adults

Abstract

Antegrade colonic enema, via a caecal access [Malone antegrade continence enema (MACE)], is proposed to selected patients suffering from incontinence and/or constipation when other therapeutic modalities have failed. We compared complication rates after three MACE techniques: appendicostomy, caecal neoappendicostomy, and ileal neoappendicostomy in 28 adult patients having 31 MACE operations. Stenoses and leakages occurred more frequently after appendicostomy and caecal flap than after ileal neoappendicostomy. This latter technique appears to reduce morbidity for adult patients.