Preliminary report: the antegrade continence enema

Malone, P.S.; Ransley, Philip G.; Kiely, Edward M.

doi:10.1016/0140-6736(90)92834-5

Cited by 803 publications

(340 citation statements)

References 3 publications

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“…The procedure involves connecting the appendix to the abdominal wall and making a valve mechanism that allows catheterization of the appendix, but avoids leakage of stool through it, thus forming an appendicostomy. 69 Consequently, a catheter can be introduced to the patient through the stoma and an enema administered. 34 Owing to the wash-out effect and perhaps the stimulated colonic peristaltic, the colon and rectum will empty, thus preventing fecal incontinence and constipation.…”

Section: Resultsmentioning

confidence: 99%

Neurogenic bowel management after spinal cord injury: a systematic review of the evidence

et al. 2010

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Study design: Randomized-controlled trials (RCTs), prospective cohort, case-control, pre-post studies, and case reports that assessed pharmacological and non-pharmacological intervention for the management of the neurogenic bowel after spinal cord injury (SCI) were included. Objective: To systematically review the evidence for the management of neurogenic bowel in individuals with SCI. Setting: Literature searches were conducted for relevant articles, as well as practice guidelines, using numerous electronic databases. Manual searches of retrieved articles from 1950 to July 2009 were also conducted to identify literature. Methods: Two independent reviewers evaluated each study's quality, using Physiotherapy Evidence Database scale for RCTs and Downs and Black scale for all other studies. The results were tabulated and levels of evidence assigned. Results: A total of 2956 studies were found as a result of the literature search. On review of the titles and abstracts, 57 studies met the inclusion criteria. Multifaceted programs are the first approach to neurogenic bowel and are supported by lower levels of evidence. Of the non-pharmacological (conservative and non-surgical) interventions, transanal irrigation is a promising treatment to reduce constipation and fecal incontinence. When conservative management is not effective, pharmacological interventions (for example prokinetic agents) are supported by strong evidence for the treatment of chronic constipation. When conservative and pharmacological treatments are not effective, surgical interventions may be considered and are supported by lower levels of evidence in reducing complications. Conclusions: Often, more than one procedure is necessary to develop an effective bowel routine. Evidence is low for non-pharmacological approaches and high for pharmacological interventions.

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Section: Resultsmentioning

confidence: 99%

Neurogenic bowel management after spinal cord injury: a systematic review of the evidence

et al. 2010

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“…Of these, three (10%) had an antegrade continence enema (ACE) [13] and two (9.5%) used daily oral medication. One of these four patients had suffered from two episodes of enterocolitis and the parents thus used rectal enemas immediately when necessary.…”

Section: Functional Resultsmentioning

confidence: 99%

“…The use of medicine to achieve normal bowel function and also if the patient had received an antegrade continence enema (ACE) [13] were noted. The author's registered soiling or faecal incontinence in those older than 3-4 years of age.…”

Section: Methodsmentioning

confidence: 99%

Development of Frequency of Stools over Time in Children with Hirschsprung Disease Posttransanal Endorectal One-Stage Pull-through

et al. 2014

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“…from a second isolated segment of ileum is saved [2]. More recently, children with a neurogenic bladder have been treated successfully for co-existing faecal incontinence using antegrade enemas through a continent appendicostomy, according to the Malone principle [5]. If such a procedure is required in association with bladder augmentation and a suprapubic stoma for catheterization, the proposed technique seems to be very attractive.…”

Section: Advantages and Disadvantagesmentioning

confidence: 99%