Quality of life in pediatric patients with unremitting constipation pre and post Malone Antegrade Continence Enema (MACE) procedure.

Abstract

OBJECTIVE:

The primary aim of this study was to determine if there is a change in the quality of life in pediatric patients with unremitting functional constipation and/or encopresis after undergoing a MACE procedure.

METHODS:

Patients, ages 5 to 18 years with unremitting constipation and a normal evaluation, including anorectal manometry and colonic manometry, who opted to undergo a MACE procedure were contacted to participate in the study. Patients with congenital anorectal malformations as well as spinal cord disorders were excluded from the study. The patient's parent/guardian completed the PedsQL(TM) Generic Core Scales QOL survey prior to the operation, 6 months, and 12 months after the procedure.

RESULTS:

A total of 15 consecutive patients meeting protocol criteria were recruited within a period of 20 months. The mean age at the MACE procedure was 9.8 years (range 7.0-11.1). 5 patients were female. The mean QOL score pre-MACE was 64.1. At 6 months post-MACE the mean overall QOL score was 90.2, and it was 92.0 at 12 months. All 15 patients at the 6 month follow up had significant improvement in their QOL (p=1.9 × 10(-7)) and all subcategories of QOL were significantly improved as well.

CONCLUSIONS:

A MACE procedure is of benefit to otherwise normal pediatric patients who have unremitting functional constipation with failure of medical treatment. Our patients had a significant improvement in all QOL categories and overall QOL.

• Authors: Aileen F Har, Frederick J Rescorla, Joseph M Croffie
• Journal: Journal of pediatric surgery (J Pediatr Surg) Vol. 48 Issue 8 Pg. 1733-7 (Aug 2013) ISSN: 1531-5037 [Electronic] United States
• PMID: 23932614 (Publication Type: Journal Article)
• Copyright: Copyright © 2013 Elsevier Inc. All rights reserved.

Chemical References

• Laxatives

Topics

• Adolescent
• Biofeedback, Psychology
• Cecostomy (psychology)
• Child
• Child, Preschool
• Chronic Disease
• Combined Modality Therapy
• Constipation (psychology, surgery, therapy)
• Encopresis (psychology, surgery, therapy)
• Enema (methods)
• Fecal Impaction (prevention & control)
• Fecal Incontinence (psychology, surgery, therapy)
• Female
• Humans
• Laxatives (therapeutic use)
• Male
• Postoperative Complications (etiology, psychology)
• Quality of Life
• Surgical Stomas