Document Detail

ouble-loop Puborectoplasty: Novel Technique for the Treatment of Fecal Incontinence.
MedLine Citation:
PMID:  19579196     Owner:  NLM     Status:  In-Data-Review    
The treatment of neurogenic and traumatic fecal incontinence (FI) as may result from severe anal sphincteric destruction is problematic. A novel technique for the treatment of these cases is presented. The study comprised 44 patients, which included 28 with neurogenic and 16 with traumatic FI. Patients were divided into two equal groups. Two fascia lata slings (FLS) were applied in Group 1, while one sling was used in Group 2. Investigations comprised manometric and electromyographic studies. The procedure consisted of performing a curvilinear incision behind the anal orifice, and the supralevator region was entered. The middle of an FLS was sutured to the back of the upper part of anal canal. Each of the two limbs of the sling was passed forward through an incision on the pubic ramus and was sutured to the periosteum of the pubic ramus. This was preformed in Groups 1 and 2. A second FLS was added in Group 1. Its center was sutured to the front of the mid anal canal and its two limbs to the coccyx. Satisfactory results (continence scores 1 and 2) were obtained in 63.6% of Group 1 and 36.4% of Group 2. Significant postoperative anal pressure increase occurred in scores 1 to 3 in Group 1 and in scores 1 to 2 in Group 2. Anal pressure increase was more prominent in Group 1 than in Group 2. The continent effect of the operation appears to be due to the increase of anal pressure, anal canal elongation, and recto-anal angulation. The operation is indicated in FI of the idiopathic or traumatic type with excessive sphincteric loss. It is simple and easy and performed under no cover of colostomy.
Ismail A Shafik; Ahmed Shafik
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgical technology international     Volume:  18     ISSN:  1090-3941     ISO Abbreviation:  Surg Technol Int     Publication Date:  2009  
Date Detail:
Created Date:  2009-07-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9604509     Medline TA:  Surg Technol Int     Country:  United States    
Other Details:
Languages:  eng     Pagination:  103-8     Citation Subset:  IM    
Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Cairo, Egypt.
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