G Meurette1, P-A Lehur, E Coron, N Regenet. 1. Institut des maladies de l'appareil digestif, Hôtel-Dieu-CHU de Nantes, 1, place Alexis-Ricordeau, 44035 Nantes cedex, France. Guillaume.meurette@chu-nantes.fr <Guillaume.meurette@chu-nantes.fr>
Abstract
AIM: The Malone antegrade colonic enema (MACE) procedure is a minimally invasive treatment for severe constipation, and the objective of the present study was to assess the long-term results and quality of life in patients undergoing such colonic irrigation. METHOD: Twenty-five adult patients underwent MACE between 1995 and 2002 for chronic constipation. After a mean follow-up duration of 55+/-36 months, the patients answered questionnaires to assess stoma usage, constipation score (KESS) and quality of life (GIQLI). RESULTS: The mean quality-of-life scores for these patients was 83+/-28 (normal: 125), while their mean constipation score was 19+/-9 (normal: <7). Twelve patients stopped the irrigations, and eight underwent further surgical procedures, specifically, total colectomy with ileostomy (n=2), ileorectal anastomosis (n=3) or segmental colectomy (n=3). Finally, five patients had permanent stoma. The 13 remaining patients continued to perform irrigations (4.6 per week). The patients' mean KESS score was 18.3+/-8 (normal: <7), and the mean GIQLI score was 98+/-20 (normal: 125). Continence status had no influence on success. CONCLUSION: In our series, MACE was successful in half the patients who were, thus, able to avoid more aggressive approaches. However, when MACE failed, other surgical procedures were often required.
AIM: The Malone antegrade colonic enema (MACE) procedure is a minimally invasive treatment for severe constipation, and the objective of the present study was to assess the long-term results and quality of life in patients undergoing such colonic irrigation. METHOD: Twenty-five adult patients underwent MACE between 1995 and 2002 for chronic constipation. After a mean follow-up duration of 55+/-36 months, the patients answered questionnaires to assess stoma usage, constipation score (KESS) and quality of life (GIQLI). RESULTS: The mean quality-of-life scores for these patients was 83+/-28 (normal: 125), while their mean constipation score was 19+/-9 (normal: <7). Twelve patients stopped the irrigations, and eight underwent further surgical procedures, specifically, total colectomy with ileostomy (n=2), ileorectal anastomosis (n=3) or segmental colectomy (n=3). Finally, five patients had permanent stoma. The 13 remaining patients continued to perform irrigations (4.6 per week). The patients' mean KESS score was 18.3+/-8 (normal: <7), and the mean GIQLI score was 98+/-20 (normal: 125). Continence status had no influence on success. CONCLUSION: In our series, MACE was successful in half the patients who were, thus, able to avoid more aggressive approaches. However, when MACE failed, other surgical procedures were often required.
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