Matsuno Daisuke, Yamazaki Yuichiro, Shiroyanagi Yoshiyuki, Ueda Nobufumi, Suzuki Mari, Nishi Morihiro, Hagiwara Ayako, Ichiroku Terumi
Department of Urology, Kanagawa Children's Medical Center, 2-138-4, Mutsukawa, Minami-ku, Yokohama, 232-8555, Japan.
Pediatr Surg Int. 2010 May;26(5):529-33. doi: 10.1007/s00383-010-2585-6. Epub 2010 Mar 3.
The aim of this study was to evaluate the efficacy of the retrograde colonic enema relative to the Malone antegrade continence enema.
We retrospectively investigated 25 children with spina bifida and fecal incontinence. Thirteen children had started retrograde colonic enema and twelve had started Malone antegrade continence enema. Fecal continence, water volume, time to washout, procedure frequency, pain during procedure, performance independence and demographical data were compared between the two groups.
Fecal continence was achieved for 10 of 13 (76.9%) in the retrograde group and 9 of 12 (75.0%) in the antegrade group. In the antegrade group 8 of 12 (66.7%) performed procedure independently, while 3 of 13 (23.1%) did so in the retrograde group. Achievement of fecal continence did not differ between the groups, but procedure independence was significantly better in the antegrade group.
Our results suggest that retrograde colonic enema was not inferior to Malone antegrade continence enema on fecal continence. We recommend considering retrograde colonic enema prior to introduction of Malone antegrade continence enema in children with spina bifida.
本研究旨在评估逆行结肠灌肠相对于马龙顺行节制灌肠的疗效。
我们回顾性调查了25例患有脊柱裂和大便失禁的儿童。13例儿童开始进行逆行结肠灌肠，12例开始进行马龙顺行节制灌肠。比较两组之间的大便节制情况、水量、冲洗时间、操作频率、操作过程中的疼痛、操作独立性和人口统计学数据。
逆行组13例中有10例（76.9%）实现了大便节制，顺行组12例中有9例（75.0%）实现了大便节制。顺行组12例中有8例（66.7%）能独立操作，而逆行组13例中只有3例（23.1%）能独立操作。两组在实现大便节制方面无差异，但顺行组在操作独立性方面明显更好。
我们的结果表明，逆行结肠灌肠在大便节制方面并不逊色于马龙顺行节制灌肠。我们建议在对患有脊柱裂的儿童引入马龙顺行节制灌肠之前，考虑采用逆行结肠灌肠。
