(Malone Procedure; Antegrade Colonic Enema Procedure)
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Reasons for Procedure
- Excess bleeding
- Adverse reaction to anesthesia such as light-headedness, low blood pressure, or wheezing
- Leakage of tube or appendix
- Blocked tube that requires a second surgery to fix it
What to Expect
Prior to Procedure
- Aspirin and other nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen
- Blood-thinning drugs
- Anti-platelet drugs
Description of the Procedure
How Long Will It Take?
Will It Hurt?
Average Hospital Stay
- Follow your doctor’s instructions on cleaning the incision site. Leave the incision open to air.
- Some leakage is normal. Try to keep area dry.
- Avoid vigorous sports or activity after surgery
- Ask your doctor about when it is safe to shower, bathe, or soak in water.
- Once recovered there should be no activity restrictions including swimming.
- Be sure to follow your doctor’s instructions.
- Leave the tube in place after surgery until your doctor lets you know it is okay to remove it.
- Tape the tube in place while you heal. This will keep the tube in ideal position.
- Follow directions to place and use the tube once you have healed.
Call Your Doctor
- Have trouble using the tube
- Tube falls out before healing time is done
- Pain that is not controlled with medication
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Abdominal pain
- Trouble passing enema through tube
American Society of Colon and Rectal Surgeons http://www.fascrs.org
American Academy of Pediatrics http://www.healthychildren.org
Canadian Association of Gastroenterology http://www.cag-acg.org/
Sick Kids http://www.sickkids.ca/
Appendicostomy (Malone Procedure). Cincinnati Children’s Hospital website. Available at: http://www.cincinnatichildrens.org/service/c/colorectal/treatments/appendicostomy/ . Accessed October 21, 2012.
Appendicostomy. Intermountain Healthcare website. Available at: https://intermountainhealthcare.org/ext/Dcmnt?ncid=521117329 . Accessed October 21, 2012.
Levitt MA, Soffer SZ, Péan A. Continent appendicostomy in the bowel management of fecally incontinent children. J Pediatr Surg . 1997 Nov;32(11):1630-3.
Taiwo A. Lawal, Shawn J. Rangel, Andrea Bischoff, Alberto Peña, and Marc A. Levitt. Journal of Laparoendoscopic & Advanced Surgical Techniques. June 2011, 21(5): 455-459.