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The results of antegrade continence enema using a retubularized sigmoidostomy

Authors
 Soo Min Ahn  ;  Sang Won Han  ;  Seung Hoon Choi 
Citation
 PEDIATRIC SURGERY INTERNATIONAL, Vol.20(7) : 488-491, 2004 
Journal Title
 PEDIATRIC SURGERY INTERNATIONAL 
ISSN
 0179-0358 
Issue Date
2004
MeSH
Abdominal Pain/prevention & control ; Adult ; Child ; Child, Preschool ; Colon, Sigmoid/surgery* ; Colostomy/methods* ; Constipation/surgery ; Enema/methods* ; Esthetics ; Fecal Incontinence/surgery* ; Female ; Follow-Up Studies ; Humans ; Male ; Sodium Chloride/administration & dosage ; Sodium Chloride/therapeutic use ; Time Factors ; Treatment Outcome ; Umbilicus/surgery
Keywords
Antegrade continence enema ; Retubularized sigmoidostomy ; Fecal continence
Abstract
Left colonic antegrade continence enema (ACE) has been reported only as an alternative to right colonic ACE—the Malone appendicostomy and Monti retubularized ileostomy. This paper evaluated the advantages of left colonic ACE using a retubularized sigmoidostomy (RS) as an appropriate method for maintaining fecal continence and as a first-line surgical treatment for patients with fecal incontinence or intractable constipation. Ten patients underwent surgery between March 2002 and June 2003: seven with meningomyelocele, one with cloacal anomaly, one with anorectal malformation, and one with lipoma of the spine. An RS tube was fashioned and then implanted using a segment of the sigmoid colon and exteriorized through the umbilicus. An enema was done 10 days after surgery using only normal saline. The outcomes were assessed after adjusting to the appropriate enema regimen for the 10 cases. The mean duration of the enema was 23.0±8.4 min, with 250 ml (range 80–800) as the median volume of fluid used. The enema interval ranged from 1–3 days. No patient showed any abdominal discomfort or soiling episodes, with the exception of one who experienced daytime fecal staining, but this occurred less than once per month. The self-cosmesis for the umbilical stoma was satisfactory. The RS procedure provided excellent continence control, with a shortening of the enema duration, a lower fluid volume, and good cosmesis, and without any ACE-related abdominal pain. This procedure can be used as a first-choice surgical treatment for intractable constipation and fecal incontinence.
Full Text
http://link.springer.com/article/10.1007%2Fs00383-004-1221-8
DOI
10.1007/s00383-004-1221-8
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Choi, Seung Hoon(최승훈)
Han, Sang Won(한상원) ORCID logo https://orcid.org/0000-0003-0941-1300
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/111260
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