Anal sphincter reconstruction by dynamic graciloplasty after abdominoperineal resection for cancer

摘要: PURPOSE: Chronic low-frequency electrical stimulation can safely transform fatiguing muscle into fatigue-resistant muscle. This fundamental discovery was used to reconstruct the anal sphincter. Dynamic graciloplasty found be effective in treatment of fecal incontinence. Our study undertaken investigate oncologic, functional, and quality life results dynamic reconstruction after an abdominoperineal resection for carcinoma. METHODS: Between April 1993 1996, nine patients (4 males) with a median age 51.2 (range, 29–69) years underwent carcinoma had rectal adenocarcinoma 5 epidermoidal tumor) sphincter electrically stimulated graciloplasty. Oncologic functional were evaluated mean follow-up 32 14–59) months. A questionnaire filled out by seven patients. RESULTS: Sphincter required same hospitalization period as resection. Two died from evolutive disease. Three operated on twice, one immediate colonic necrosis, two perforation enema. One them refused Six dysfunctioned. The resting pressure 24±10 mmHg, during 95±25 mmHg. Five continent solids liquid; four wore less than three pads per day, more three. Four enemas twice week; patient spontaneous evacuation. showed that scores social interaction, symptoms, psychological physical states 2.1, 2.2, 2.4, 2.7, respectively. value 1.5 CONCLUSIONS: Total anorectal is oncologically safe procedure. Functional improve time, but careful selection guarantees successful outcome. Technical progress necessary life.