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Poster Display - 99
Long-Term and Short-Term Follow-Up After the Malone Procedure: Evaluation of Complications and Quality of Life Compared with a Bowel Management Program
Mehrdad Hosseinpour, Amir Farhang
Isfahan University of Medical Sciences,Departement of Pediatric Surgery,Isfahan, Iran
Purpose:
TheTransumbilical Laparoscopic-Assisted Malone (TULAM) procedure, introduced in 1990, is a convenient method for colonic washout. However, complications remain a concern for surgeons. This study aimed to evaluate postoperative complications and assess quality of life (QoL) in patients undergoing TULAM, in comparison with outcomes following a Bowel Management Program (BMP).
Methods:
Patients who underwent TULAM between March 2019 and March 2022 were followed for complications at 6 months and 1 year post-surgery. Quality of life was assessed using the Pediatric Quality of Life Inventory (PedsQL) before and after BMP, as well as pre- and post-TULAM.
Results:
Among 32 patients who underwent TULAM, three developed stomal stenosis and experienced painful catheterization at 6 months postoperatively. These issues resolved with daily stoma intubation. Four patients developed granulation tissue at the stoma site, with one requiring surgical revision. The mean QoL score improved from 57.67 ± 21.09 pre-BMP to 71.30 ± 17.48 post-BMP. Similarly, QoL significantly improved postoperatively compared to preoperative scores.
Conclusion:
TULAM appears to be an effective procedure for antegrade colonic enema (ACE) in patients with chronic constipation and fecal incontinence (CCFI). It is associated with manageable complications and a sustained improvement in quality of life, observable from early postoperative periods and continuing over time.