{'fraction_non_alphanumeric': 0.019809825673534072, 'fraction_numerical': 0.006339144215530904, 'mean_word_length': 5.315, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Paediatric laparoscopic surgery issue.

African degenerative leiomyopathy (ADL) is a rare disorder of unknown aetiology seen in African children, predominantly in southern and south-eastern Africa. The pathology involves degeneration of smooth muscle with replacement by fibrous tissue. Predominantly affecting the rectum and colon, ADL presents as chronic intestinal pseudo-obstruction, and anorexia and malnutrition are hallmarks of the disease. The disease is universally fatal in the second or third decade of life. Management is traditionally conservative, with surgery restricted to the management of complications. Over the past 15 years we have placed Malone antegrade continence enema (MACE) stomas in the grossly dilated colon to vent accumulated gas and administer antegrade bowel enemas. This is done mainly for relief of gaseous distension and constipation in an attempt to provide symptomatic relief and improve quality of life. Our operative strategy evolved from an open modified MACE procedure to currently using a laparoscopically assisted technique to insert a Mic-Key gastrostomy device as a ‘button colostomy’. We present our preliminary results of this procedure in 8 patients over the past 61⁄2 years with follow-up of 6 months to 6 years.