Left colonic antegrade continence enema: experience gained from 19 cases.
OBJECTIVE
As problems have developed with the right colonic antegrade continence enema procedure (Malone's procedure/Monti's retubularized ileocolostomy), left colonic antegrade continence enema (LACE) procedure, in which retubularized ileum or sigmoid colon is anastomosed into the sigmoid colon, has gained popularity. The aim of the study was to describe our experience with the LACE procedure.


METHODS
We retrospectively reviewed 19 LACE procedures that were performed at the Yonsei University College of Medicine Hospital (Seoul, Korea) from March 2001 to March 2005.


RESULTS
Male-to-female ratio was 11:8, with median age of 10 years (range, 3-34 years). Most common diagnosis was meningomyelocele (78.9%, 15/19). The median total follow-up period was 23 months (range, 3-37 months); median antegrade continence enema volume used was 600 mL (range, 250-1500 mL); and median transit time was 30 minutes (range, 15-60 minutes). Patients performed antegrade continence enema with an average of once every 2 days (range, 0.3-3 days). Social continence was achieved in 14 patients (73.7%). Regurgitation of fecal material through stoma was not reported at all in 17 patients (89.5%).


CONCLUSIONS
We recommend LACE as the procedure of choice for children with congenital malformations or any other condition predisposing to fecal incontinence or constipation intractable to conventional treatment.
Kim
Seong Min
SM
Division of Pediatric Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul 120-752, South Korea.
Han
Sang Won
SW
Choi
Seung Hoon
SH
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003106:Colon / Q000601:surgery*; D003125:Colostomy; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D004733:Enema / Q000009:adverse effects / Q000379:methods*; D005242:Fecal Incontinence / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D007081:Ileostomy; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome