Colorectal Quiz: Episode 43
Topic overview
Expert pediatric colorectal surgeons discuss clinical aspects of the Malone antegrade continence enema (MACE) procedure in an interactive quiz format. This case-based educational episode focuses on surgical technique and patient selection for bowel management in children with fecal incontinence.
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Key takeaways
- Malone antegrade continence enema (MACE) procedure creates a catheterizable channel for antegrade colonic irrigation in fecal incontinence patients.
- Patient selection is critical: MACE works best for motivated patients with adequate cognitive function to perform daily irrigations.
- Common complications include stomal stenosis, leakage, and catheterization difficulty requiring revision in 20-30% of cases.
- Success rates approach 70-80% when combined with appropriate bowel management protocols and patient/family education.
- Alternative appendicostomy sites and cecostomy tubes offer flexibility when appendix is unavailable or previous MACE has failed.
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