Neurovascular intact muscle transposition for anal sphincter repair. Experimental model and experience with dynamic pacing.

摘要: PURPOSE: To study muscle behavior for anal sphincter repair, radiologic, manometric, and histologic techniques in a dog animal model have been used. Special attention was given to the problem of resting length transposed muscle. METHODS: The semitendinosus could be successfully create new based on an intact neurovascular pedicle. parallel-fibered split at its distal end encircled around canal. Manometry performed intraoperatively postoperatively. A sufficiently high basal squeeze pressure had obtained guarantee final continent neosphincter. This realized by progressive stretching until maximum is reached. In one pacemaker implanted, postoperatively fixed stimulation protocol started. Muscle biopsies normal neosphincter were taken. RESULTS: 1) transposition gave degree continence this experimental model, with mean ±40 mmHg squeezing ±73 mmHg. 2) Electric influenced but not pressure. 3) fiber type composition changed toward slow after fast even more stimulation. CONCLUSIONS: Creation cuff can substitute sphincter. Adequate stretch fibers essential continence. Electrical pacing helps preserve tension subsequent