Comparison of epineural or intramuscular nerve electrodes for stimulated graciloplasty

Diseases of the Colon and Rectum
J KonstenN S Williams

Abstract

Two different techniques have been developed to stimulate the gracilis muscle when it is used in anal neosphincter reconstruction. These are direct neural stimulation and intramuscular electrode stimulation. The aim of this study was to compare these techniques. Comparison was made of gracilis anal neosphincter reconstruction using neural stimulation (Royal London Hospital in the United Kingdom) with the intramuscular muscular method (University Hospital Maastricht in the Netherlands). The United Kingdom data were obtained from a retrospective database, whereas the Netherlands data were gathered prospectively. A successful outcome was achieved in 46 of 81 patients (57 percent) in London and 148 of 200 cases (74 percent) in the Maastricht study (chi-squared = 7.2; P < 0.01). There was no significant difference between the two techniques in voltage required for stimulation of the neosphincter muscle during a ten-year period. Reoperative surgery for electrode failure or dislocation was required in 21 (26 percent) patients in the London study, whereas only four (2.7 percent) of the Maastricht cases required such procedures (chi-squared = 37.8; P < 0.05). The high electrode plate failure rate in the London study was related to the s...Continue Reading

References

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Citations

Dec 18, 2001·Microsurgery·C G BaetenM J Rongen
Feb 1, 2005·Clinics in Colon and Rectal Surgery·Susan M Cera, Steven D Wexner
Mar 8, 2006·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·J R SaundersN S Williams
May 6, 2015·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·UNKNOWN Italian Society of Colorectal Surgery (SICCR)Paolo Usai Satta
Jan 12, 2019·Annals of Plastic Surgery·Amish Jayantilal GohilSukria Nayak
Mar 11, 2020·Journal of Neuroengineering and Rehabilitation·Kadir A YildizKenton R Kaufman

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