PMID: 9427866Jan 1, 1997Paper

Total anorectal reconstruction--fact or fiction

Swiss Surgery = Schweizer Chirurgie = Chirurgie Suisse = Chirurgia Svizzera
C G Baeten, M J Rongen

Abstract

Continuous electrical stimulation of a transposed gracilis muscle around an anatomically intact, but not functioning anus, proved to give a good continence even after many years. The procedure of pull through the colon and creation of a neo anus is indicated for a limited group of patients after Miles resection, trauma and atresia patients. In a series of 21 patients with abdomino-perineal pull through and the construction of a neo anus with a double dynamic graciloplasty, there was an enormous difference between the patients who underwent this reconstruction in the same operation as the abdomino-perineal resection (n = 14) and the patients who had the pull through several years after the Miles resection (n = 7). Reasonable continence was achieved in 8 out of the primary 14 operated patients and only 3 out of the 7 secondary operated patients. We can conclude that creation of a complete neo anus after a pull through is technically possible, and will result in an acceptable continence in about half the patients. Quality of continence will never be the same as in patients with a normal anatomical anus due to lack of sensibility.

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