Long-term outcomes of a Malone antegrade continence enema (MACE) for the treatment of fecal incontinence or constipation in adults

Autor: A. Ahmad, Rosel Sturkenboom, A. A. van der Wilt, S.M.J. van Kuijk, Paul T.J. Janssen, Laurents P. S. Stassen, Stephanie O. Breukink, Jarno Melenhorst
Přispěvatelé: RS: CAPHRI - R2 - Creating Value-Based Health Care, Promovendi MHN, RS: MHeNs - R3 - Neuroscience, Neurochirurgie, RS: SHE - R1 - Research (OvO), Surgery, MUMC+: MA Heelkunde (9), MUMC+: MA AIOS Heelkunde (9), RS: NUTRIM - R2 - Liver and digestive health
Rok vydání: 2018
Předmět:
Adult
Male
medicine.medical_specialty
Constipation
Visual analogue scale
DISORDERS
Long Term Adverse Effects
Pain
Enema
030230 surgery
KARNOFSKY PERFORMANCE STATUS
03 medical and health sciences
0302 clinical medicine
Malone antegrade continence enema
Postoperative Complications
Quality of life
HEALTH SURVEY SF-36
QUALITY-OF-LIFE
Surveys and Questionnaires
Colostomy
Outcome Assessment
Health Care
medicine
MANAGEMENT
Fecal incontinence
Humans
Defecation
Netherlands
Pain Measurement
Retrospective Studies
SACRAL NERVE-STIMULATION
business.industry
Mortality rate
General surgery
Gastroenterology
COLONIC ENEMA
Postoperative complication
Middle Aged
RELIABILITY
SLOW-TRANSIT CONSTIPATION
Quality of Life
EXPERIENCE
030211 gastroenterology & hepatology
Female
medicine.symptom
business
Mace
Fecal Incontinence
Zdroj: International Journal of Colorectal Disease, 33(10), 1341-1348. Springer, Cham
ISSN: 1432-1262
0179-1958
Popis: Purpose The aim of the study was to assess the long-term outcome of a Malone antegrade continence enema (MACE) procedure for fecal incontinence or constipation in adults. Methods This retrospective single-center study assessed the long-term outcome and quality of life (QoL) of patients who underwent a MACE procedure between 2005 and 2014 at the Maastricht University Medical Centre. Success rate was quantified by using Malone's continence scale. Quality of life was assessed by validated questionnaires covering general quality of life (SF-36 and Karnofsky scale), current pain level (visual analog scale), fecal incontinence (Vaizey incontinence survey), or constipation (Cleveland Clinic Constipation Score). Results Based on patients' records, 22 out of 30 patients (73%; 95% CI 54-87%) were still using their MACE. Mean follow-up was 43 months (SD 25.9) since time of surgery. According to the Malone continence scale, the overall success rate was 37% (95% CI 20.0-53.3). Nine patients developed a postoperative complication. Eighteen out of 22 patients (13 with constipation and 5 with fecal incontinence) returned the QoL questionnaires (82% response rate). Long-term quality of life of patients with a MACE did not differ from the general Dutch population. Conclusions In our cohort of patients with fecal incontinence or constipation, MACE resulted in a disappointed overall success rate of 37%. However, it may be indicated in patients who do not prefer more invasive surgical procedures or a definite stoma. The success and morbidity rate should be thoroughly discussed with the patients preoperatively.
Databáze: OpenAIRE
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