Antegrade Continence Enema를 이용한 배변실금의 치료 효과
The Result of Antegrade Continence Enema for Fecal Incontinence -Experience of Eighteen Patients with Menigomyelocele-
김현영, 정성은, 이성철, 박귀원, 김우기,
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김현영 ( Kim Hyun-Young )
서울대학교 의과대학 외과학교실
정성은 ( Jung Sung-Eun )
서울대학교 의과대학 외과학교실
이성철 ( Lee Seong-Cheol )
서울대학교 의과대학 외과학교실
박귀원 ( Park Kwi-Won )
서울대학교 의과대학 외과학교실
김우기 ( Kim Woo-Ki )
서울대학교 의과대학 외과학교실
KMID : 0371320030640040306
Abstract
PURPOSE: Fecal incontinence as a result of anorectal malformation, Hirschsprung’s disease, and spina bifida remains a major problem for patients, their families, and for surgeons. The aim of this study was to evaluate the results of an antegrade continence enema (ACE) in children suffering from fecal incontinence.
METHODS: An ACE was performed in 18 patients with fecal incontinence due to meningomyelocele between January 1998 and May 2002. Three operative methods were applied: reversed appendicostomy (1/18), orthotopic appendicostomy (5/18) and neoappendicostomy with cecal flap (12/18). The enema solutions used in our patients were the Fleet enema solution, the solin enema solution and the Soft-soap enema solution etc.
RESULTS: The overall success rate was 83%. The most common complication was abdominal pain (77.7%) with the other complications being stoma stricture (11.1%), stoma leakage (11.1%), as well as stoma infection, diarrhea, nausea, vomiting and epigastric soreness. The success of the surgical techniques, the regulation of fecal soiling, and improvement in the quality of life for the patients and their families were evaluated according to the Johns Hopkins Hospital’s scoring system. The improvement in the quality of life was 87% with a mean follow-up period of 24 months.
CONCLUSION: An ACE procedure appears to be a safe and effective approach for the control of fecal incontinence in pediatric patients with menigomyelocele and significantly improves the quality of life for nearly all patients.
키워드
뇌척수 수막류;배변실금;선행성 관장법
Menigomyelocele;Fecal incontinence;Antegrade continence enema
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