Transumbilical laparoscopy-assisted Malone procedure for fecal incontinence in children

Background: Transumbilical laparoscopy-assisted Malone procedure (TULAM) is a single-incision laparoscopic procedure in which the appendicostomy is made at umbilicus. The aim of this study is to evaluate the outcomes of TULAM. Methods: With IRB approval, the medical records of the patients who under...

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Main Authors: Hsuan Huang, Yih-Cherng Duh, Paul Chia-Yu Chang, Yu-Wei Fu, Yao-Jen Hsu, Fu-Huan Huang, Ming-Hung Shen, Chin-Hung Wei
Format: Article
Language:English
Published: Elsevier 2022-03-01
Series:Pediatrics and Neonatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1875957221002205
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author Hsuan Huang
Yih-Cherng Duh
Paul Chia-Yu Chang
Yu-Wei Fu
Yao-Jen Hsu
Fu-Huan Huang
Ming-Hung Shen
Chin-Hung Wei
author_facet Hsuan Huang
Yih-Cherng Duh
Paul Chia-Yu Chang
Yu-Wei Fu
Yao-Jen Hsu
Fu-Huan Huang
Ming-Hung Shen
Chin-Hung Wei
author_sort Hsuan Huang
collection DOAJ
description Background: Transumbilical laparoscopy-assisted Malone procedure (TULAM) is a single-incision laparoscopic procedure in which the appendicostomy is made at umbilicus. The aim of this study is to evaluate the outcomes of TULAM. Methods: With IRB approval, the medical records of the patients who underwent TULAM were retrospectively reviewed between July 2013 and December 2018. The data collected included ages, gender, underlying diseases, operative techniques, complications, stoma continence, parental satisfaction and follow-up duration. Results: Fifteen patients underwent TULAM at the median age of 5.0 years (2.9–10.7 years). There were 4 girls and 11 boys. Thirteen patients had anorectal malformations or cloaca; the other two patients had spina bifida. All patients presented with fecal incontinence; 9 of them had concomitant constipation. TULAM was successfully accomplished in 14 patients; one patient required conversion to the three-port procedure. The median follow-up period was 1.7 years (0.5–3.2 years). One patient required tube replacement under endoscopy guidance in the operation room. One patient required surgical revision because the appendix was disrupted after an episode of enterocolitis. All patients were socially continent with antegrade enemas. 12 patients were stoma continent, and 3 patients had minor leaking less than once a month. The stoma cosmesis was satisfactory. All parents expressed satisfaction with TULAM. Conclusion: TULAM is effective in the management of fecal incontinence and constipation, and provides a continent stoma with excellent cosmesis.
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spelling doaj-art-e6e7e4f5e2fb49bab02543e0ca8f4d5d2025-08-20T03:04:01ZengElsevierPediatrics and Neonatology1875-95722022-03-0163215415810.1016/j.pedneo.2021.07.010Transumbilical laparoscopy-assisted Malone procedure for fecal incontinence in childrenHsuan Huang0Yih-Cherng Duh1Paul Chia-Yu Chang2Yu-Wei Fu3Yao-Jen Hsu4Fu-Huan Huang5Ming-Hung Shen6Chin-Hung Wei7Division of Pediatric Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei, TaiwanDivision of Pediatric Surgery, Department of Surgery, Mackay Memorial Hospital, Hsinchu, Taiwan; Mackay Junior College of Medicine, Nursing, and Management, TaiwanDivision of Pediatric Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, TaiwanDepartment of Pediatric Surgery, Changhua Christian Hospital, Changhua, TaiwanDepartment of Pediatric Surgery, Changhua Christian Hospital, Changhua, TaiwanDivision of Pediatric Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan; Department of Biological Science and Technology, National Chiao-Tung University, Hsinchu, TaiwanDepartment of Surgery, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan; School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, TaiwanDivision of Pediatric Surgery, Department of Surgery, Shuang Ho Hospital, New Taipei City, Taiwan; Department of Surgery, School of Medicine, Taipei Medical University, Taipei, Taiwan; Corresponding author. No.291, Zhongzheng Rd., Zhonghe Dist., New Taipei City 235, Taiwan.Background: Transumbilical laparoscopy-assisted Malone procedure (TULAM) is a single-incision laparoscopic procedure in which the appendicostomy is made at umbilicus. The aim of this study is to evaluate the outcomes of TULAM. Methods: With IRB approval, the medical records of the patients who underwent TULAM were retrospectively reviewed between July 2013 and December 2018. The data collected included ages, gender, underlying diseases, operative techniques, complications, stoma continence, parental satisfaction and follow-up duration. Results: Fifteen patients underwent TULAM at the median age of 5.0 years (2.9–10.7 years). There were 4 girls and 11 boys. Thirteen patients had anorectal malformations or cloaca; the other two patients had spina bifida. All patients presented with fecal incontinence; 9 of them had concomitant constipation. TULAM was successfully accomplished in 14 patients; one patient required conversion to the three-port procedure. The median follow-up period was 1.7 years (0.5–3.2 years). One patient required tube replacement under endoscopy guidance in the operation room. One patient required surgical revision because the appendix was disrupted after an episode of enterocolitis. All patients were socially continent with antegrade enemas. 12 patients were stoma continent, and 3 patients had minor leaking less than once a month. The stoma cosmesis was satisfactory. All parents expressed satisfaction with TULAM. Conclusion: TULAM is effective in the management of fecal incontinence and constipation, and provides a continent stoma with excellent cosmesis.http://www.sciencedirect.com/science/article/pii/S1875957221002205anorectalmalformationfecal incontinencelaparoscopymalone antegrade continence enemaspinabifida
spellingShingle Hsuan Huang
Yih-Cherng Duh
Paul Chia-Yu Chang
Yu-Wei Fu
Yao-Jen Hsu
Fu-Huan Huang
Ming-Hung Shen
Chin-Hung Wei
Transumbilical laparoscopy-assisted Malone procedure for fecal incontinence in children
Pediatrics and Neonatology
anorectalmalformation
fecal incontinence
laparoscopy
malone antegrade continence enema
spinabifida
title Transumbilical laparoscopy-assisted Malone procedure for fecal incontinence in children
title_full Transumbilical laparoscopy-assisted Malone procedure for fecal incontinence in children
title_fullStr Transumbilical laparoscopy-assisted Malone procedure for fecal incontinence in children
title_full_unstemmed Transumbilical laparoscopy-assisted Malone procedure for fecal incontinence in children
title_short Transumbilical laparoscopy-assisted Malone procedure for fecal incontinence in children
title_sort transumbilical laparoscopy assisted malone procedure for fecal incontinence in children
topic anorectalmalformation
fecal incontinence
laparoscopy
malone antegrade continence enema
spinabifida
url http://www.sciencedirect.com/science/article/pii/S1875957221002205
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