The electrically stimulated gracilis neosphincter incorporated as part of total anorectal reconstruction after abdominoperineal excision of the rectum

Annals of Surgery
B J ManderN S Williams

Abstract

The authors investigated the feasibility and effectiveness of combining electrically stimulated gracilis neoanal (ESGN) sphincter and a coloperineal anastomosis in selected patients after abdominoperineal excision of the rectum (APER). The ESGN is effective in the treatment of idiopathic fecal incontinence. Between March 1989 and September 1993, 12 patients (9 men, 3 women) with a median age of 59.25 years (range, 45-70) underwent the procedure. The underlying disease was adenocarcinoma in 10, anal malignant melanoma in 1, and a sweat gland tumor in the other. In all patients, a sphincter saving resection was contraindicated. The procedure was performed in stages. Stage 1 involved a conventional APER with the formation of a perineal stoma. Eleven patients underwent a vascular delay procedure. All patients were defunctioned. In stage 2, the gracilis was mobilized, transposed around the anal canal, and the electrodes and hardware needed for electrical stimulation were implanted. Once muscle conversion was complete, the defunctioning stoma was closed. Eight patients were closed successfully. In seven of the eight patients, complete physiologic measurements were taken. Median basal and maximum neosphincter pressures were 30 and 122...Continue Reading

References

May 1, 1976·The British Journal of Surgery·O S SimonsenA Habr-Gama
Sep 1, 1992·Diseases of the Colon and Rectum·E P PélissierJ F Bosset
Nov 9, 1991·Lancet·C G BaetenP B Soeters
Nov 9, 1991·Lancet·N S WilliamsE S Watkins
Nov 1, 1989·The British Journal of Surgery·N S WilliamsE S Watkins
Feb 1, 1989·Diseases of the Colon and Rectum·V D Fedorov, Y A Shelygin
Feb 1, 1986·The British Journal of Surgery·R ParcJ Loygue
Jul 1, 1995·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·B P GeerdesC G Baeten
Sep 1, 1994·Diseases of the Colon and Rectum·M SecciaE Cavina
May 1, 1993·World Journal of Surgery·J KonstenP B Soeters
Jan 1, 1996·The British Journal of Surgery·J F AbercrombieN S Williams

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Citations

Aug 10, 2006·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·O RuthmannH J Schrag
Sep 18, 2007·Diseases of the Colon and Rectum·Jane J Y TanJoe J Tjandra
Dec 14, 1999·The British Journal of Surgery·B J ManderM R Keighley
Dec 21, 2000·The British Journal of Surgery·D A Niriella, K I Deen
Jun 5, 2003·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·H. R RosenR Schiessel
Jun 5, 2003·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·G. RomanoP. Esposito
Jan 1, 2010·Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland·N Abbes OrabiA Kartheuser
Apr 25, 2014·Gastroenterology Report·Andrew P Zbar
Jul 30, 2014·Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society·Abhijit ChandraRavindra K Garg
Mar 23, 2005·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·V VioliL Roncoroni
May 13, 2004·Surgical Oncology Clinics of North America·Vipul R Dev, Abhay Gupta
Apr 28, 2007·International Journal of Surgery·K S GurusamyH Benziger
Nov 19, 2014·International Journal of Colorectal Disease·Roman A InglinDaniel Candinas
Oct 6, 1997·The British Journal of Surgery·R S RataniN S Williams
Jul 24, 1998·Annals of Medicine·J Christiansen

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