Bilateral gluteoplasty for fecal incontinence

Devesa, J. M.; Madrid, Jose Manuel; Gallego, Begoña Rodríguez; Vicente, Emilio; Nuño, Javier; Enriquez, J.

doi:10.1007/bf02051193

Cited by 63 publications

(24 citation statements)

References 8 publications

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“…The gluteoplasty has less traction on the neurovascular pedicle and is thought to be anatomically a safer procedure than graciloplasty [24][25][26]. The modified transposition of gracilis muscle has reduced potential danger of stretch injury to neurovascular pedicle.…”

Section: Discussionmentioning

confidence: 99%

New Rectal Construction After Abdominoperineal Resection for Carcinoma Rectum

Chivate¹,

Chougule²

2012

Indian J Surg

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The results of the new reconstruction of the rectum after Abdominoperineal Resection (APR) with 'S'-trap arrangement of the colon and continent perineal colostomy controlled by adynamic bilateral graciloplasty are evaluated. The fully stretched gracilis muscles were utilized for occlusion of the lumen of the colon. METHODS and MATERIALS: Between April 1993 and December 2006, selected 42 patients (30 males and 12 females) with median age of 43.5 years (25-64 years) were treated by a one-stage procedure without colonic diversion. All patients were suffering from adenocarcinoma of the lower third of the rectum. The abdominoperineal resection was carried out in all cases. A 25-cm-long vascular segment of the colon was installed in the sacral curve and 'S'-shaped trap was developed with fixed colonic curves at the coccyx and to the left ischial rami of the pubic bone. The left gracilis was wrapped around just distal to the fixed curve of the colon to the left ischial rami and right one around the perineal colostomy with different grades of tightness. Continence was satisfactory in 34 patients; they could hold more than 1,000 ml of saline. Occasional soiling was reported in the night in 8 patients. All patients have achieved near-natural continence. The new rectal reconstruction with 'S' arrangement of colon and continent perineal colostomy achieved near-natural continence in 66% of cases.

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Section: Discussionmentioning

confidence: 99%

New Rectal Construction After Abdominoperineal Resection for Carcinoma Rectum

Chivate¹,

Chougule²

2012

Indian J Surg

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“…Bessere Ergebnisse sind bei der alternativen bilateralen Glutealplastik beschrieben [8,12].Verschiedene Konfigurationen sind bei der Umlegung des Anus möglich (Abb. 2).…”

Section: Glutealplastikunclassified

“…Obwohl einige akzeptable Ergebnisse mit dieser Methode beschrieben sind [8,12], liegt die Erfolgsrate bei der nichtstimulierten Gracilisplastik und Glutealplastik unter 50% der Fälle [6]. Viele Patienten, die nach Anwendung dieser Verfahren kontinent, sind leiden unter chronischer Obstipation.…”

Section: Glutealplastikunclassified

Sphinkterersatzplastiken

Koch

Baeten

2003

Chirurg

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An anal sphincter replacement graft can be carried out when sphincter lesions occur after unsuccessful conservative or other treatment. Today, two different techniques are used to take over the function of the sphincter. The dynamic gracilis graft can be carried out if a non-atrophied,well innervated m. gracilis is present. This technique is carried out on patients whose incontinence is the result of a trauma,pudendopathy or imperforate anus. It can be extended to the construction of a neo-anus after abdominal resection. The artificial anal sphincter is used whenever the previous method fails or can not be used due to a non-vital, denervated or the lack of the m. gracilis. Older methods such as non-stimulated gracilis, glureus or Thiersch grafts are not commonly used.

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“…Various procedures have been tried such as postanal repair, 2 total pelvic floor repair, 3 and muscle transposition procedures. 4 Recent developments in dynamic graciloplasty, 5 artificial bowel sphincter procedures, 6 and sacral nerve stimulation 7 are considered to be promising. Unfortunately, these procedures require special equipment and their utility is limited because there is high morbidity to consider, which discourages coverage by insurers.…”

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confidence: 99%