Belgian experience with dynamic graciloplasty for faecal incontinence

Abstract

DGP is a major operation with a high morbidity rate; it requires experience and early muscle training. The outcome after DGP should be compared prospectively with that after implantation of an artificial sphincter or other less expensive alternatives.

Neosphincter Surgery for Fecal Incontinence: A Critical and Unbiased Review of the Relevant Literature

“…The electrodes may be implanted at the level of the muscle, as described by Baeten et al,11 or at the level of the nerve, as described by Williams et al,4 or at the level of both muscle and nerve. 12 Subsequently, the leads are tunneled subcutaneously to a pocket in the lower abdominal wall, beneath the rectus fascia, and connected to a pulse generator. All implanted devices are soaked in gentamicin solution.…”

Fecal incontinence: an up-to-date critical overview of surgical treatment options

“…A specific complication with this method is the late anorectal perforation, caused by erosion of the tendon during stimulation [25,26]. According to most recent publications, complication rate is more than 50%, and overall success rate is below 35% [27,28]. DGP is largely limited to a small number of centers in which adequate patient volume and surgical experience help assure acceptably low morbidity and satisfactory functional outcomes [18].…”

Transplante anorretal como proposta terapêutica para o tratamento de incontinência fecal e colostomia definitiva

“…A graciloplastia dinâmica tem demonstrado taxa de sucesso variável em torno de 60 a 80% no tratamento da incontinência fecal em algumas séries limitadas de pacientes [73][74][75][76][77] . No entanto, estudos mais recentes, inclusive um estudo prospectivo multicêntrico de Metzel et al 79 , demonstram taxas de sucesso não superiores a 45% em dois anos, com maior taxa de sucesso no primeiro ano 78,79 . Além disso, a taxa de complicações importantes nestes estudos giraram em torno de 40%, muitas delas de tratamento cirúrgico.…”