Non-dynamic graciloplasty is an effective treatment for patients with passive fecal incontinence

Author(s):  
M. E. Knol ◽  
H. S. Snijders ◽  
M. C. DeRuiter ◽  
S. M. P. Koch ◽  
J. T. M. van der Heyden ◽  
...  
2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Piotr Walega ◽  
Michal Romaniszyn ◽  
Benita Siarkiewicz ◽  
Dorota Zelazny

Purpose. The aim of the study is to compare functional results of end-stage fecal incontinence treatment with dynamic graciloplasty and adynamic graciloplasty augmented with transanal conditioning of the transposed muscle.Methods. A total of 20 patients were qualified for graciloplasty procedure due to end-stage fecal incontinence. 7 patients underwent dynamic graciloplasty (DGP), whereas 13 patients were treated with adynamic graciloplasty, with transanal stimulation in the postoperative period (AGP). Clinical, functional, and quality of life assessments were performed 3, 6, and 12 months after the procedures.Results. There were no intraoperative or early postoperative complications. The detachment of gracilis muscle tendon was observed in one patient in DGP group and two in AGP group. There was a significant improvement of Fecal Incontinence Quality of Life (FIQL) and Fecal Incontinence Severity Index (FISI) scores in both groups 12 months after procedure. Anorectal manometry showed improvement regarding basal and squeeze pressures in both groups, with significantly better squeeze pressures in AGP group.Conclusions. The functional effects in the DGP and AGP groups were similar. Significantly lower price of the procedure and avoidance of implant-related complication risk suggest the attractiveness of the AGP method augmented by transanal stimulation.


Microsurgery ◽  
2001 ◽  
Vol 21 (6) ◽  
pp. 230-234 ◽  
Author(s):  
Cor G.M.I. Baeten ◽  
�zen� Uludag ◽  
Mart-Jan Rongen

1995 ◽  
Vol 332 (24) ◽  
pp. 1600-1605 ◽  
Author(s):  
Cor G.M.I. Baeten ◽  
Bastiaan P. Geerdes ◽  
Eddy M.M. Adang ◽  
Erik Heineman ◽  
Joop Konsten ◽  
...  

2018 ◽  
Vol 29 (03) ◽  
pp. 276-281
Author(s):  
Johan Danielson ◽  
Urban Karlbom ◽  
Tomas Wester ◽  
Wilhelm Graf

Purpose Dynamic graciloplasty (DGP) has been used to treat severe fecal incontinence since the 1980s. Previous studies have shown an inferior outcome in patients with anorectal malformations (ARMs). Our experience has been that DGP has been appreciated by ARM -patients. The objective of the study was to evaluate the long-term outcome of DGP in our patients with ARM compared with patients with other underlying conditions. Materials and Methods Twenty-three patients operated with DGP at our institution from 1996 to 2010 were sent validated bowel function and quality of life questionnaires. Eighteen of 23 responded. Seven had ARM and 11 had other etiologies of fecal incontinence. The mean follow-up time was 11.6 years (range, 5–17). Results Four of 7 of the patients with ARM and 8 of 11 of patients with other etiologies used their implants at follow-up. The Miller incontinence score was slightly higher for patients with ARMs, but they had less constipation and higher Fecal Incontinence Quality of Life (FIQL)- and 36-Item Short Form Health Survey (SF-36) scores. None of the differences were statistically significant. Conclusion This study cannot confirm earlier reports in which DGP has an inferior outcome in patients with ARM. We therefore believe that the procedure should remain a treatment option for selected patients.


2000 ◽  
Vol 5 (1) ◽  
Author(s):  
S. RODASKI ◽  
S. D. GUÉRIOS ◽  
A. B. KOPPE ◽  
P. C. SINCERO ◽  
M. V. TRANQUILIN ◽  
...  

A incontinência fecal em cães e gatos é uma situação na qual o proprietário tem dificuldades para resolver as conseqüências advindas desta lesão, e geralmente os pacientes são submetidos à eutanásia. Algumas técnicas cirúrgicas empregadas na esfincteroplastia são passíveis de complicações como estenose anal ou incontinência fecal. Este experimento teve como objetivo reconstituir o músculo esfíncter anal externo em cães, após iatrogenização da incontinência fecal. Foram utilizados 10 cães hígidos, machos, sem raça definida, com peso variando entre 9 a14 kg. Após incisão de pele circundando a abertura anal, procedeu-se a miectomia bilateral de esfíncter anal externo, iatrogenizando-se a incontinência fecal, a qual foi diagnosticada por meio de avaliação física diária. Trinta dias após, os pacientes foram novamente preparados para cirurgia asséptica e submetidos à esfincteroplastia anal externa com o uso de Fascia lata autológa medindo 8 cm de comprimento e 0,5 cm de largura, em média. Os dez cães incontinentes, em decorrência da miectomia do esfíncter anal externo, apresentaram controle da emissão de fezes em 10 dias após a realização da esfincteroplastia e mantiveram-se assim durante os dois meses de observação póscirúrgica. Dessa maneira concluiu-se que a mioplastia do esfíncter anal externo com Fascia lata autóloga, representa um procedimento eficaz de simples e rápida aplicação, podendo ser utilizado rotineiramente para restabelecer a continência fecal em cães. Experimental myoplasty of the external anal sphincter with autologous Fascia lata in dogs Abstract Fecal incontinence in dogs and cats is a hard condition for owners to solve the consequences of this lesion, being patients usually subjected to euthanasia. Some surgical techniques used in sphincteroplasty are prone to complications such as anal stenosis or fecal incontinence. This experiment objectified to reconstruct the external anal sphincter in dogs after iatrogeny of the fecal incontinence. Ten healthy male dogs of undefined breed, weight ranging from 9 to 14 kg, were used. After dermal incision surrounding the anal opening, bilateral myectomy of the external anal sphincter was performer, with iatrogeny of fecal incontinence, diagnosed by daily physical evaluation. Thirty days later, patients were again prepared for aseptic surgery and went under external anal sphincteroplasty using autologous Fascia lata averaging 8 cm long and 0,5 cm wide. Ten incontinent dogs, due to external anal sphincter myectomy, presented fecal control in ten days after surgery and for the two subsequent months of follow-up. In conclusion, myoplasty of external anal sphincter using autologous Fascia lata is a simple and effective treatment that can be used in fecal incontinence in dogs.


2002 ◽  
Vol 45 (6) ◽  
pp. 809-818 ◽  
Author(s):  
Steven D. Wexner ◽  
Cor Baeten ◽  
Randolph Bailey ◽  
Arne Bakka ◽  
Bruce Belin ◽  
...  

2014 ◽  
Vol 109 ◽  
pp. S527
Author(s):  
Francis Okeke ◽  
Ahmed Salem ◽  
John Clarke ◽  
Sameer Dhalla ◽  
Monica Nandwani ◽  
...  

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