Neosphincters in the management of faecal incontinence

Abstract

Neoanal sphincter operations are technically demanding, require a considerable learning experience and should be confined to specialist colorectal centres. Patients are likely to benefit from a plan that incorporates preoperative counselling and a selective approach.

Dynamic Graciloplasty Resulting Fecal Continence Without Electrical Stimulation: Report of a Case

“…16 However, many reports have shown an improved continence rate ranging from 79% to 100%. [6][7][8][9][10][11] The following two points should thus be reconsidered: (1) is a prolonged contraction essential for fecal continence? and (2) is the nervous activity of the gracilis unchangeable?…”

“…Although there is a report of negative results of unstimulated graciloplasty, 5 most reports showed an improved continence rate ranging from 79% to 100%. [6][7][8][9][10][11] However, the operation remains in disfavor without any evidence to show whether the transposed gracilis muscle actually works. We demonstrate the movement of the transposed gracilis muscle in a patient after dynamic Reprint requests to: T. Shatari, Department of Surgery, The University of Birmingham, Edgbaston, Birmingham B15 2TT, UK Received: September 17, 2002 / Accepted: July 8, 2003 The colostomy was closed after 3 months.…”

Anal incontinence—sphincter ani repair: indications, techniques, outcome

“…Long-term follow-up shows that at 5 years only 16% have completely normal continence [21,49,50]. Due to the high morbidity and mortality of this procedure and the other safer options available, this procedure is reserved for patients with significant tissue loss who are not candidates for other procedures.…”

Diagnostik und Therapie der Stuhlinkontinenz

“…Neben diesen technischen Details muss bedacht werden, dass die Anwendung dieses Verfahrens auch ein bestimmtes Maß an Compliance von dem Patienten erfordert. Der Patient muss in der Lage sein, die technischen Hintergründe zu verstehen und den Impulsgeber zur Stuhlentleerung unter Umstän-den auszuschalten und danach wieder anzustellen [1,13].…”