Usefulness of the Monti–Malone procedure as a reconstruction of the antegrade continence enema procedure: a case report
Abstract Background The antegrade continence enema (ACE) procedure is effective for severe constipation in patients with spina bifida and can improve quality of life (QOL). The Monti–Malone procedure (MM), which is a method of creating an enema tract from the colon, has been reported as an alternati...
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| Format: | Article |
| Language: | English |
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Japan Surgical Society
2021-05-01
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| Series: | Surgical Case Reports |
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| Online Access: | https://doi.org/10.1186/s40792-021-01197-5 |
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| author | Koichi Saito Yoshiaki Kinoshita Yoshiaki Takahashi Takashi Kobayashi Yuhki Arai Toshiyuki Ohyama Naoki Yokota |
| author_facet | Koichi Saito Yoshiaki Kinoshita Yoshiaki Takahashi Takashi Kobayashi Yuhki Arai Toshiyuki Ohyama Naoki Yokota |
| author_sort | Koichi Saito |
| collection | DOAJ |
| description | Abstract Background The antegrade continence enema (ACE) procedure is effective for severe constipation in patients with spina bifida and can improve quality of life (QOL). The Monti–Malone procedure (MM), which is a method of creating an enema tract from the colon, has been reported as an alternative to the ACE procedure when the appendix cannot be used. We report the usefulness of MM as a reconstruction of the antegrade continence enema procedure. Case presentation Our patient was a 22-year-old man with congenital spina bifida and hydrocephalus. Ventriculoperitoneal (VP) shunt surgery was performed immediately after birth, and preventative appendectomy was carried out during VP shunt repair when 4 months old. At 5 years of age, the ACE procedure using a balloon-button gastrostomy tube was performed for intractable chronic constipation. Simple management was expected, but after 17 years of age, he experienced increased stool leakage around the gastrostomy tube and his QOL declined due to difficulty in managing the ACE. Therefore, reconstruction of the ACE procedure by MM was performed. After reconstruction, the ACE performed well without any complications. The patient is currently satisfied because management of the ACE is easier than before, and his QOL has markedly improved without stool leakage and dermatitis. Conclusions MM is less likely to cause complications and is useful as a reconstruction of the ACE procedure. |
| format | Article |
| id | doaj-art-3e1df34996074a629263f0c6cfa32115 |
| institution | DOAJ |
| issn | 2198-7793 |
| language | English |
| publishDate | 2021-05-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-3e1df34996074a629263f0c6cfa321152025-08-20T02:52:42ZengJapan Surgical SocietySurgical Case Reports2198-77932021-05-01711410.1186/s40792-021-01197-5Usefulness of the Monti–Malone procedure as a reconstruction of the antegrade continence enema procedure: a case reportKoichi Saito0Yoshiaki Kinoshita1Yoshiaki Takahashi2Takashi Kobayashi3Yuhki Arai4Toshiyuki Ohyama5Naoki Yokota6Department of Pediatric Surgery, Niigata University Graduate School of Medical and Dental SciencesDepartment of Pediatric Surgery, Niigata University Graduate School of Medical and Dental SciencesDepartment of Pediatric Surgery, Niigata University Graduate School of Medical and Dental SciencesDepartment of Pediatric Surgery, Niigata University Graduate School of Medical and Dental SciencesDepartment of Pediatric Surgery, Niigata University Graduate School of Medical and Dental SciencesDepartment of Pediatric Surgery, Niigata University Graduate School of Medical and Dental SciencesDepartment of Pediatric Surgery, Niigata University Graduate School of Medical and Dental SciencesAbstract Background The antegrade continence enema (ACE) procedure is effective for severe constipation in patients with spina bifida and can improve quality of life (QOL). The Monti–Malone procedure (MM), which is a method of creating an enema tract from the colon, has been reported as an alternative to the ACE procedure when the appendix cannot be used. We report the usefulness of MM as a reconstruction of the antegrade continence enema procedure. Case presentation Our patient was a 22-year-old man with congenital spina bifida and hydrocephalus. Ventriculoperitoneal (VP) shunt surgery was performed immediately after birth, and preventative appendectomy was carried out during VP shunt repair when 4 months old. At 5 years of age, the ACE procedure using a balloon-button gastrostomy tube was performed for intractable chronic constipation. Simple management was expected, but after 17 years of age, he experienced increased stool leakage around the gastrostomy tube and his QOL declined due to difficulty in managing the ACE. Therefore, reconstruction of the ACE procedure by MM was performed. After reconstruction, the ACE performed well without any complications. The patient is currently satisfied because management of the ACE is easier than before, and his QOL has markedly improved without stool leakage and dermatitis. Conclusions MM is less likely to cause complications and is useful as a reconstruction of the ACE procedure.https://doi.org/10.1186/s40792-021-01197-5Antegrade continence enemaMonti–Malone procedureConstipation |
| spellingShingle | Koichi Saito Yoshiaki Kinoshita Yoshiaki Takahashi Takashi Kobayashi Yuhki Arai Toshiyuki Ohyama Naoki Yokota Usefulness of the Monti–Malone procedure as a reconstruction of the antegrade continence enema procedure: a case report Surgical Case Reports Antegrade continence enema Monti–Malone procedure Constipation |
| title | Usefulness of the Monti–Malone procedure as a reconstruction of the antegrade continence enema procedure: a case report |
| title_full | Usefulness of the Monti–Malone procedure as a reconstruction of the antegrade continence enema procedure: a case report |
| title_fullStr | Usefulness of the Monti–Malone procedure as a reconstruction of the antegrade continence enema procedure: a case report |
| title_full_unstemmed | Usefulness of the Monti–Malone procedure as a reconstruction of the antegrade continence enema procedure: a case report |
| title_short | Usefulness of the Monti–Malone procedure as a reconstruction of the antegrade continence enema procedure: a case report |
| title_sort | usefulness of the monti malone procedure as a reconstruction of the antegrade continence enema procedure a case report |
| topic | Antegrade continence enema Monti–Malone procedure Constipation |
| url | https://doi.org/10.1186/s40792-021-01197-5 |
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