Evidence map›Paper›PMID 41483410›Full record

SynthesisInternational journal of colorectal disease2026

The Malone antegrade continence enema for treating adult constipation and fecal incontinence: a systematic review of the literature.

Gaetano Gallo, Veronica De Simone, Alex Bruno Bellocchia, Salvatore Sorrenti, Alberto Realis Luc, Giuseppe Clerico, Roberto Sorge, Pierpaolo Sileri, Mario Trompetto, Gianpiero Gravante

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in International journal of colorectal disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Gaetano GalloFaculty of Medicine and Surgery, Colorectal Surgery Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute University, Via Olgettina 60, 20132, Milan, Italy.
Veronica De SimoneFaculty of Medicine and Surgery, Colorectal Surgery Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute University, Via Olgettina 60, 20132, Milan, Italy.
Alex Bruno BellocchiaDepartment of General Surgery, Maria Vittoria Hospital, Turin, Italy.
Salvatore SorrentiDepartment of Surgery, Sapienza" University of Rome, Rome, Italy. salvatore.sorrenti@uniroma1.it.
Alberto Realis LucDepartment of Colorectal Surgery, S. Rita Clinic, Vercelli, Italy.
Giuseppe ClericoDepartment of Colorectal Surgery, S. Rita Clinic, Vercelli, Italy.
Roberto SorgeDepartment of Human Physiology, Laboratory of Biometry, University of Tor Vergata in Rome, Rome, Italy.
Pierpaolo SileriFaculty of Medicine and Surgery, Colorectal Surgery Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute University, Via Olgettina 60, 20132, Milan, Italy.
Mario TrompettoDepartment of Colorectal Surgery, S. Rita Clinic, Vercelli, Italy.
Gianpiero GravanteDepartment of General Surgery, Azienda Sanitaria Locale ASL Lecce, Casarano, Italy. ggravante@hotmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe Malone antegrade continence enema (MACE) offers a minimally invasive and potentially reversible option for managing chronic constipation and fecal incontinence (FI). This systematic review evaluates its efficacy, safety, and long-term outcomes in adults.

methodsA comprehensive search was conducted across PubMed, EMBASE, and CENTRAL databases up to April 2025 to identify studies on MACE in adults. Study quality was assessed using the Newcastle-Ottawa scale. The primary outcome was the proportion of patients continuing MACE at follow-up (treatment success); failure was defined as conversion to definitive colostomy.

resultsSeventeen studies with 404 patients were included. Study quality was rated moderate to good. The most common indications were neurological disorders (25.8%), prior surgeries (16.8%), idiopathic constipation (14.2%), and traumatic spinal injuries (11.6%). Techniques included terminal ileal loop (37.9%), percutaneous endoscopic cecostomy (26.0%), and appendicostomy (24.8%). Minor stoma-related complications were most frequent (39.1%), followed by fecal leakage (16.2%) and stoma stenosis (11.3%). Median follow-up was 28.5 months. At final follow-up, 75.1% of patients continued using MACE, while 9.8% required colostomy. Satisfactory outcomes were reported by 60%-83% of patients, with improvements in symptoms and quality of life.

conclusionsMACE is a safe and effective option for adults with refractory constipation or FI, especially in those aiming to avoid a permanent colostomy.

Indexed as

ConstipationEnemaFecal IncontinenceAdultFemaleHumansMaleTreatment OutcomeAntegrade continence enemaColostomyConstipationFecal incontinenceNeurogenic bowel dysfunction

Identifiers

PMID41483410
PMCPMC12764679

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.