Karmarkar S J, Sushma Achugatla, Bangar A P, Krishnan J
Senior Consultant Paediatric Surgeon, Department of Pediatric Surgery, Lilavati Hospital and Research Centre, Maharashtra, India.
Senior DNB Pediatric Surgery Resident, Department of Pediatric Surgeon, Lilavati Hospital and Research Centre, Maharashtra, India.
J Indian Assoc Pediatr Surg. 2023 Jul-Aug;28(4):288-292. doi: 10.4103/jiaps.jiaps_40_23. Epub 2023 Jul 11.
The aim of this study was to present the long-term institutional experience and outcomes of our Malone antegrade continence enema (MACE) procedure using the proximal appendix without any antireflux procedure.
A single-center prospective study of 29 children undergoing a simplified Malone antegrade continence enema (SMACE) procedure from 2006 to 2017 was conducted using the appendix, whole or split. The mean follow-up period was 11.5 years (ranging from 5 to 16 years).
In 25 children, the proximal appendix was used, and in 4 cases, the whole appendix was used as a conduit. On follow-up, the MACE channel has been working well in 29/29 patients. Among the complications, seven patients had stomal stenosis, which was managed by home dilatation. There was no reflux of stools seen in any of the patients.
The SMACE procedure, without incorporating an antireflux mechanism, is technically simpler and saves operative time. Most importantly, the results are satisfactory and comparable with procedures using antireflux techniques.
本研究的目的是介绍我们使用近端阑尾且不进行任何抗反流手术的马龙顺行性节制灌肠（MACE）手术的长期机构经验及结果。
对2006年至2017年期间接受简化马龙顺行性节制灌肠（SMACE）手术的29名儿童进行了单中心前瞻性研究，使用完整或分段的阑尾。平均随访期为11.5年（5至16年）。
25名儿童使用近端阑尾，4例使用完整阑尾作为管道。随访时，MACE通道在29/29例患者中运作良好。并发症方面，7例患者出现造口狭窄，通过家庭扩张处理。所有患者均未出现大便反流。
不纳入抗反流机制的SMACE手术在技术上更简单，节省手术时间。最重要的是，结果令人满意，与使用抗反流技术的手术相当。
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