Use of a continent colonic conduit for treatment of refractory evacuatory disorder following construction of an electrically stimulated gracilis neoanal sphincter
| Autor: | N. S. Williams, A. J. P. Eccersley, J. R. Saunders |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Reoperation medicine.medical_specialty Reconstructive surgery Colon medicine.medical_treatment Electric Stimulation Therapy Stoma Postoperative Complications Refractory Colostomy medicine Humans In patient Therapeutic Irrigation Postoperative Care business.industry Anastomosis Surgical Colonic conduit Enema Middle Aged Surgery Plastic surgery Treatment Outcome medicine.anatomical_structure Chronic Disease Sphincter Female business Fecal Incontinence Follow-Up Studies |
| Zdroj: | British Journal of Surgery. 90:1416-1421 |
| ISSN: | 1365-2168 0007-1323 |
| Popis: | Background This study reports the outcome from the addition of a continent colonic conduit (CCC) to an electrically stimulated gracilis neoanal sphincter in patients with severe evacuatory disorder following formation of a neosphincter for end-stage faecal incontinence. Methods One hundred and twenty patients had an electrically stimulated gracilis neoanal sphincter constructed for end-stage faecal incontinence. Seven patients developed severe evacuatory disorders; construction of a CCC was required in six patients and an antegrade continence enema procedure in one. Results Median follow-up of the seven patients was 77 (range 6–96) months. Six patients with evacuatory disorders had a successful outcome, defined as continence to solid and liquid stool as well as correction of the evacuatory disorder. A stoma was formed in one patient. Patients who had previously undergone anorectal reconstructive surgery were more likely to develop an evacuatory disorder following construction of an electrically stimulated gracilis neoanal sphincter than patients operated on for other reasons (χ2 = 28·13, 1 d.f., P < 0·001). Conclusion Construction of a CCC is a useful technique for the majority of patients with severe evacuatory disorders following the formation of an electrically stimulated gracilis neoanal sphincter, for whom the only alternative would be an end stoma. A CCC may be incorporated with construction of an electrically stimulated gracilis neoanal sphincter in patients at significant risk of postoperative severe evacuatory disorders. |
| Databáze: | OpenAIRE |
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