This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Outcome of antegrade continence enema procedures for faecal incontinence in adults. BJS 2006; 93: 1265-1269.
Published: 4th September 2006
Authors: J. H. Lefèvre, Y. Parc, G. Giraudo, S. Bell, R. Parc, E. Tiret et al.
Background
Faecal incontinence has major consequences. Colostomy has been the mainstay of therapy when other options fail. Operations such as the Malone procedure have been proposed as an alternative. The aim of this study was to evaluate the outcomes and quality of life of patients having a Malone procedure for the treatment of faecal incontinence.
Method
Charts of patients who had had a Malone procedure or equivalent between 1998 and 2004 were reviewed. The patients completed a Short Form (SF) 36 quality of life questionnaire.
Results
The study included 25 patients (17 female; median age 47 years). In seven, the appendix was used; an ileoneoappendicostomy was performed in the other 18. Three patients were lost to follow‐up; the remaining 22 were followed for a median (range) of 21 (1–61) months. Five patients had a cutaneous stenosis; another had the appendicostomy removed and replaced by a colostomy. Four patients no longer used the stoma for irrigation. All other patients were completely clean except one, who reported occasional night‐time seepage. The mean SF‐36 showed a good physical recovery (43·9) but persisting psychological distress (36·0).
Conclusion
The Malone procedure or equivalent achieves good results in the management of faecal incontinence, although psychological distress persists after surgery. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
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