scholarly journals MIOPLASTIA EXPERIMENTAL DO ESFÍNCTER ANAL EXTERNO COM Fascia lata AUTÓLOGA, EM CÃES

2000 ◽  
Vol 5 (1) ◽  
Author(s):  
S. RODASKI ◽  
S. D. GUÉRIOS ◽  
A. B. KOPPE ◽  
P. C. SINCERO ◽  
M. V. TRANQUILIN ◽  
...  
Keyword(s):  
Fecal Incontinence ◽  
Effective Treatment ◽  
Anal Sphincter ◽  
External Anal Sphincter ◽  
Surgical Techniques ◽  
Fascia Lata ◽  
Anal Stenosis ◽  
Healthy Male ◽  
Anal Sphincteroplasty

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.

scholarly journals ESFINCTEROPLASTIA ANAL EXTERNA EXPERIMENTAL COM MEMBRANA DE PERITÔNIO BOVINO PRESERVADA EM GLICERINA A 98%, EM CÃES

2000 ◽  
Vol 5 (1) ◽  
Author(s):  
S. RODASKI ◽  
S. D. GUÉRIOS ◽  
M. A. PERRONI ◽  
A. B. NARDI ◽  
C. A. M. SILVA
Keyword(s):  
Fecal Incontinence ◽  
Anal Sphincter ◽  
External Anal Sphincter ◽  
Subcutaneous Tissue ◽  
Biological Membrane ◽  
Continuous Suture ◽  
Anal Opening ◽  
Perineal Region

A incontinência fecal em cães pode ser neurogênica ou conseqüente às miopatias da região perineal, principalmente em relação ao esfíncter anal externo. Nas extensas ressecções como nos casos de neoplasias perineais, pode haver comprometimento do esfíncter anal externo e inabilidade para retenção de fezes. Tendo em vista a dificuldade dos proprietários conviverem com animais incontinentes, este experimento tem como objetivo restabelecer a função do músculo esfíncter anal externo com enxerto de membrana biológica conservada em glicerina 98%. Trinta dias após iatrogenização de incontinência através da miectomia bilateral do esfíncter anal externo, procedeu-se a esfincteroplastia. Para isso foram realizadas duas incisões de 2 cm, laterais a abertura anal, e através dessas foram feitos dois túneis no tecido subcutâneo, um dorsal e outro ventral, com o auxílio de pinça hemostática curva de Halstead. Após a tunilização, inseriu-se um segmento de peritônio bovino medindo em média 6 cm de comprimento e 0,5 cm de largura. As extremidades da membrana foram unidas através de duas suturas interrompidas simples, e após isto, fixou-se o peritônio ao músculo coccígeo com três suturas interrompidas simples e fio polipropileno no. 3-0. Na seqüência, procedeu-se a sutura contínua simples do tecido subcutâneo com fio categute simples no. 3-0 e aproximou-se as bordas da pele através de suturas interrompidas simples com fio mononáilon no. 3-0. Os dez cães, machos, sem raça definida, com peso variando entre 8 e 12 kg apresentaram controle da emissão de fezes em 10 dias, após a realização da esfincteroplastia, e permaneceram continentes durante os dois meses de observação pós-operatória. External anal experimental esphincteroplasty in dogs with bovine peritoneum membrane preserved in 98% glicerine Abstract Fecal incontinence in dogs can be either neurogenic or due to myopathies in the perineal region, mainly in relation to the external anal sphincter. In large resections as in cases of perineal neoplasias, there may be damage of the external anal sphincter and incapability of fecal control. Once it is hard for owners to cope with incontinent animals, this experiment objectifies to re-establish the functioning of the muscle of the external anal sphincter by grafting a biological membrane preserved in glycerine 98%. Sphincteroplasty was held 30 days after incontinence iatrogeny, through a bilateral myectomy of the external anal sphincter. Two incisions of 2cm at both sides of the anal opening were performed, followed by two ventral and dorsal tunnels opened through the subcutaneous tissue using Halsted’s curved hemostatic forceps. After tunneling, a segment of bovine peritoneum was inserted, 6 cm long and 0,5 cm wide, Membrane ends were put together by two plain interrupted sutures and after this procedure, peritoneum was attached to coccigean muscle by three plain interrupted sutures with polypropylene thread no. 3-0. It was followed by a plain continuous suture of the subcutaneous tissue with catgut no.3-0, putting dermal ends together through plain interrupted sutures with mononylon thread no. 3-0. Ten (10) male dogs of undefined breed, weight ranging from 8 to 12 kg presented fecal control ten days after sphincteroplasty and remained continent for the two subsequent months of follow-up.

Stress, Urge, and Mixed Types of Partial Fecal Incontinence: Pathogenesis, Clinical Presentation, and Treatment

2007 ◽  
Vol 73 (1) ◽  
pp. 6-9
Author(s):  
Ahmed Shafik ◽  
Olfat El Sibai ◽  
Ismail A. Shafik ◽  
Ali A. Shafik
Keyword(s):  
Fecal Incontinence ◽  
Anal Sphincter ◽  
Internal Anal Sphincter ◽  
External Anal Sphincter ◽  
Clinical Presentation ◽  
Individual Treatment ◽  
Electromyographic Activity ◽  
Postanal Repair ◽  
Different Types ◽  
Mixed Types

The authors investigated the hypothesis that partial fecal incontinence (PFI) had variable manifestations that can be categorized as different types of PFI with different pathogeneses and treatment. Anal and rectal pressures as well as external and internal anal sphincter electromyographic activity were recorded in 163 patients with PFI and in 25 healthy volunteers. Patients were treated with biofeedback or surgically. Three types of PFI were encountered: stress fecal incontinence (SFI; 55 patients), urge fecal incontinence (UFI; 72 patients), and mixed fecal incontinence (MFI; 36 patients). Anal pressure decreased in three groups in which MFI had the lowest pressure. A significant reduction in external anal sphincter electromyographic activity occurred in SFI, in internal anal sphincter electromyographic activity in UFI, and of both sphincters in MFI. Bio-feedback cured 36 of 55 patients and postanal repair cured 10 of 19 patients with SFI. Forty-eight of 72 patients with UFI responded to biofeedback and 16 of 24 responded to internal anal sphincter repair. Biofeedback failed in MFI patients. Twenty-four of 27 patients who consented to operative correction of the sphincteric defect were cured. Three types of PFI could be identified: SFI, UFI, and MFI. Each type has its own etiology and symptoms, and requires individual treatment. Biofeedback succeeded in treating the majority of SFI and UFI patients. Surgical correction of the anal sphincter was performed after biofeedback failure.

scholarly journals Innervation Zones of the External Anal Sphincter in Healthy Male and Female Subjects

Digestion ◽  
2004 ◽  
Vol 69 (2) ◽  
pp. 123-130 ◽  
Author(s):  
P. Enck ◽  
H. Franz ◽  
F. Azpiroz ◽  
X. Fernandez-Fraga ◽  
H. Hinninghofen ◽  
...  
Keyword(s):  
Anal Sphincter ◽  
External Anal Sphincter ◽  
Healthy Male ◽  
Male And Female ◽  
Female Subjects

MRI in Evaluating Atrophy of the External Anal Sphincter in Patients with Fecal Incontinence

2006 ◽  
Vol 187 (4) ◽  
pp. 991-999 ◽  
Author(s):  
Maaike P. Terra ◽  
Regina G. H. Beets-Tan ◽  
Victor P. M. van der Hulst ◽  
Marije Deutekom ◽  
Marcel G. W. Dijkgraaf ◽  
...  
Keyword(s):  
Fecal Incontinence ◽  
Anal Sphincter ◽  
External Anal Sphincter

scholarly journals Short- and Long-Term Outcomes of Overlap Anal Sphincter Repair for Fecal Incontinence Following Sphincter Injury

2021 ◽  
Vol 41 (01) ◽  
pp. 030-036
Author(s):  
Kasun Lakmal ◽  
Oshan Basnayake ◽  
Umesh Jayarajah ◽  
Dharmabandhu N Samarasekera
Keyword(s):  
Fecal Incontinence ◽  
Anal Sphincter ◽  
Surgical Techniques ◽  
Sphincter Repair ◽  
Significant Heterogeneity ◽  
Long Term Outcomes ◽  
Sphincter Injury ◽  
Short And Long Term ◽  
Poor Outcomes

Abstract Objective Several techniques are used to repair the anal sphincter following injury. The aim of the present study is to comprehensively analyze the short- and long-term outcomes of overlap repair following anal sphincter injury. Methods A search was conducted in the PubMed, Medline, Embase, Scopus and Google Scholar databases between January 2000 and January 2020. Studies that described the outcomes that are specific to overlap sphincter repair for fecal incontinence with a minimum follow-up period of one year were selected. Results A total of 22 studies described the outcomes of overlap sphincter repair. However, 14 studies included other surgical techniques in addition to overlap repair, and were excluded from the analysis. Finally, data from 8 studies including 429 repairs were analyzed. All studies used at least one objective instrument; however, there was significant heterogeneity among them. Most patients were female (n = 407; 94.87%) and the mean age of the included individuals was 44.6 years. The majority of the procedures were performed due to obstetric injuries (n = 384; 89.51%). The eight included studies described long-term outcomes, and seven of them demonstrated statistically significant improvements regarding the continence; one study described poor outcomes in terms of overall continence. The long-term scores were significantly better compared with the preoperative scores. However, compared with the short-term scores, a statistically significant deterioration was noted in the long-term. Conclusion The majority of the studies described good long-term outcomes in terms of anal continence after overlap sphincter repair. However, further studies are needed to identify the factors associated with poor outcomes to assist in patient selection for overlap repair.

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