This preliminary study describes the use of a new device to treat fecal incontinence. Compared with existing devices, implantation is simple and it requires no adjustments from the physician or patient once the device is implanted. Initial assessment with a small number of patients shows promising outcomes with a limited incidence of complications and good restoration of continence.

The effect of retrograde colonic washout was significantly better in spinal cord lesion and idiopathic fecal incontinence than in idiopathic constipation, and its effect correlated with the extent to which the irrigation fluid had entered the colorectum.

No abstract

Impairment of the anorectal sensibility appears to be part of the normal ageing process, thus increasing the risk of faecal incontinence in old women.

This study was performed to evaluate the validity of the bursting strength test of experimental anastomoses. By a combination of measuring the intraluminal physiological pressure during the test procedure with a radiological detection of the anastomosed intestinal segment until disruption it was demonstrated that the bursting pressure is a meaningful parameter since the maximum pressure equals the time of anastomotic leak. At day 6 60% of the tested segments disrupted outside the anastomotic line. This indicates that the bursting strength test is not a valid measure for determining the strength of colonic anastomoses after the 4th to 5th postoperative day. Moreover, the bursting wall tension parameter was evaluated. Assessment of the anastomotic radius demonstrated significant differences when the anastomotic radius at disruption was determined from the amount of inflated contrast compared with the radius detected radiologically. These differences had the effect that the wall tension at burst compared with the wall tension determined from direct radius measurement on day 4 was 61 % higher than the wall tension determined from the amount of inflated contrast with no correction for elongation of the tested segment, and 36% higher than the wall tension determined from the amount of inflated contrast and corrected for elongation of the segment. No differences in the bursting strength were found between inflation rates of 2.5 and 5.0 ml·min^–1. In conclusion, the bursting strength test is a meaningful parameter since the maximum physiological pressure equals the time of anastomotic radiological disruption, and the bursting pressure is a more exact parameter for measuring the bursting strength than the bursting wall tension.

No abstract

Aim The aim was to study anorectal function in long‐term survivors after combined, curatively intended, chemoradiotherapy and endorectal brachytherapy for low rectal cancer. Methods This was a case–control design. We compared anorectal function by anal manometry, anal functional lumen imaging probe (EndoFLIP) and rectal bag distension in rectal cancer patients (RCPs) and healthy, normal subjects (NSs). Symptoms were assessed by the low anterior resection syndrome (LARS) and Wexner faecal incontinence scores. Results Thirteen RCPs (12 men, median age 68 years, range 52–92) after 60 Gy radiotherapy, 5 Gy endorectal brachytherapy and oral tegafur‐uracil with complete clinical response (median time since treatment 2.8 years, range 2.2–5.6) were compared to 15 NSs (14 men, median age 64 years, range 47–75). RCPs had lower than normal anal resting pressure, 38.6 mmHg (range 8.8–67.7) versus 58.8 mmHg (25.7–105.2) (P < 0.003), and squeeze pressure, 117 mmHg (55.2–203) versus 188 mmHg (103–248) (P < 0.01). Squeeze‐induced pressure increase recorded by EndoFLIP was also lower in RCPs (q > 7.56, P < 0.001) as was the anal canal resistance to increasing distension (q = 3.13, P < 0.05). No differences in median rectal volume at first sensation (72 [22–158] vs. 82 [36–190] ml, P = 0.4) or at urge to defaecate (107 [42–227] vs. 132 [59–334] ml, P = 0.2) were found. However, maximum tolerable rectal volume was lower in RCPs (145 [59–319] vs. 222 [106–447] ml, P < 0.02). The median (range) low anterior resection syndrome score was 27 (0–39) for RCPs and 7 (0–23) for NSs (P < 0.001), while the Wexner score was 0 (0–5) versus 0 (0–4) (P = 0.56). Conclusion Radiotherapy combined with endorectal brachytherapy for rectal cancer causes long‐term anorectal symptoms, impaired anal sphincter function and reduced rectal capacity.

No abstract