Article

Retrospective chart review. Objective:To evaluate the clinical
outcomes and factors influencing patient satisfaction with Malone antegrade
continence enema (MACE) in patients with spina bifida.Setting:Japan.Methods:We
performed retrospective analysis of 21 patients with spina bifida who underwent
surgical creation of an MACE stoma. Clinical outcomes were evaluated by medical
records, operative notes and mailed questionnaires. Patient satisfaction scores
(SSs) were measured on a modified visual analog scale (VAS) from 1 to 10, and the
factors influencing the SS were analyzed.Results:A 100% return rate for the
mailed questionnaires was achieved. All patients underwent in situ
appendicocecostomy with cecal plication. There was only one complication that
required surgical revision. Regarding fecal continence, the overall success rate
was 90%. Although 4 patients (19%) had severe irrigation pain and 4 patients
(19%) found the washout time intolerably long, 18 (85%) of them were satisfied
with the MACE procedure. Age at operation, experience of retrograde colonic enema
(RCE), experience of stomal leakage, increased comfort at school or workplace and
increased comfort at sleepovers significantly influenced SSs.Conclusion:MACE is a
valuable option in achieving fecal continence in patients with spina bifida, with
most patients being satisfied with the procedure. In our analysis, younger age at
operation, previous experience of RCE, no stomal leakage and improvement of
quality of life (enhanced comfort at school, workplace and sleepovers)
significantly influenced the high satisfaction after MACE.

Langue : ANGLAIS