Abstract
Purpose
Malone antegrade continence enemas (MACE) provide a conduit in which the patient can
achieve improved continence, be clean of stool, and gain independence in maintaining
bowel function. The Mini-ACE® is a low-profile balloon button that is used to facilitate
the administration of antegrade enemas. We sought to describe our practice and short-term
outcomes.
Methods
This work is a retrospective review of the Mini-ACE® appendicostomy button from April
2019 to March 2021, with follow-up concluding in October 2021. Patient demographics,
colorectal diagnoses, and outcomes were examined.
Results
Forty-three patients underwent Mini-ACE® placement; 22 (51%) were male. The average
age at Mini-ACE® insertion was 9.2 years (range 3–20 years). The most common diagnoses
were functional constipation in 19 (44%), anorectal malformation in 15 (35%), and
Hirschsprung disease in 3 (7%), spinal differences 3 (7%). There were no intra-operative
complications, but 5 (12%) required prolapse resection. The median length of stay
was two days (IQR 1, 4). Patients achieved self-catheterization at 4.5 [3,7] months
from MACE creation, with 38 children (88%) reporting excellent success in remaining
clean of stool.
Conclusion
The Mini-ACE® appears to be a safe and low-profile option for antegrade continence
enema access. Further research is needed directly comparing complications and patient
satisfaction rates between different MACE devices and overall quality of life.
Level of evidence
Level IV.
Keywords
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Article info
Publication history
Published online: December 24, 2021
Accepted:
December 14,
2021
Received in revised form:
November 29,
2021
Received:
August 6,
2021
Identification
Copyright
© 2021 Published by Elsevier Inc.
