Yamamoto T, Kubo H, Honzumi M
Second Department of Surgery, Mie University School of Medicine, Tsu, Japan.
Surg Today. 1996;26(12):1024-8. doi: 10.1007/BF00309967.
Two children with intractable fecal incontinence after correction of high anorectal malformations were successfully managed by the daily administration of a glycerin enema into the cecum via an appendicocecostomy or tubularized cecostomy, according to the method of Malone's antegrade continence enema (ACE). Fluoroscopic defecography performed during this procedure in each patient disclosed that the glycerin enema promptly evoked cecal peristalsis, which was transmitted to the distal colon and rectum, and squeezed out almost all the fecal matter, evacuating it from the anus. However, two enemas within a short interval were required to achieve a complete washout of feces. Although this report describes only two patients, our experience confirmed that the ACE was very effective and that adding the word "continence" to antegrade enema was justifiable. Moreover, fluoroscopic defecography was proven to play a significant role in determining the appropriate regimens of this technique to achieve complete washout of the feces.
两名患有高位肛门直肠畸形矫正术后顽固性大便失禁的儿童，按照马龙顺行性节制灌肠术（ACE）的方法，通过阑尾盲肠造口术或管状化盲肠造口术每日向盲肠内注入甘油灌肠剂，成功得到了治疗。在此过程中，对每位患者进行的荧光透视排便造影显示，甘油灌肠剂能迅速诱发盲肠蠕动，该蠕动传导至远端结肠和直肠，并挤出几乎所有粪便，使其从肛门排出。然而，需要在短时间内进行两次灌肠才能彻底清除粪便。尽管本报告仅描述了两名患者，但我们的经验证实，ACE非常有效，并且在顺行性灌肠前加上“节制”一词是合理的。此外，荧光透视排便造影在确定该技术的合适方案以彻底清除粪便方面被证明发挥了重要作用。
