{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T11:01:35Z","timestamp":1785841295561,"version":"3.56.0"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,9,28]],"date-time":"2015-09-28T00:00:00Z","timestamp":1443398400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>We evaluated the long\u2010term results with a left antegrade continence enema (LACE) approach: \u201cMacedo\u2013Malone (MM) procedure\u201d to define parameters such as clinical durability of the technique and patients' compliance with the method.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed the medical records of all patients that underwent the MM procedure in our institution since 2001 and conducted a telephonic interview to investigate the use of the enema and satisfaction with the procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010five MM procedures were performed, but eight patients lost to follow\u2010up were excluded. Fifteen patients (55%) were female. Myelomeningocele was the clinical diagnoses in 25 (93%). Mean age at surgery was 9 years (3\u201327 years) and mean follow\u2010up was 75 months (median: 56 months). The indication for LACE was clinically intractable constipation with fecal leakage. Most patients still used the stoma regularly to do the enema (74%). Mean washout time was 27\u2009min (2\u201390\u2009min). The revision rate due to stenosis was 22.2% (6\/27) and all underwent suprafascial revision. We performed one classical MACE by infrafascial approach as a salvage procedure. Overall reoperation rate was 25.8% and fecal continence was 89%. There were no reports of leakage through the stoma. Among patients who still used the stoma, 74% were satisfied with surgery and would strongly recommend the procedure to another patient.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The MM procedure is a straightforward procedure, which can be performed in 15\u201320\u2009min, avoids additional entero\u2013entero anastomosis, precludes the use of the appendix, and has shown comparable results to either \u201cclassical\u201d MACE or other LACE variants. <jats:italic>Neurourol. Urodynam. 36:111\u2013115, 2017<\/jats:italic>. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.22880","type":"journal-article","created":{"date-parts":[[2015,9,29]],"date-time":"2015-09-29T00:57:51Z","timestamp":1443488271000},"page":"111-115","source":"Crossref","is-referenced-by-count":9,"title":["Left\u2010colon antegrade enema (LACE): Long\u2010term experience with the Macedo\u2010Malone approach"],"prefix":"10.1002","volume":"36","author":[{"given":"Christophe B.","family":"Anselmo","sequence":"first","affiliation":[{"name":"Federal University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael D.R.","family":"do Amaral","sequence":"additional","affiliation":[{"name":"Federal University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego E.G.","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Federal University of 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