The Combination of Electrically Stimulated Gracilis Neoanal Sphincter and Continent Colonic Conduit: A Step Forward for Total Anorectal Reconstruction?

Abstract

The combination of antegrade irrigation via a colonic conduit or an antegrade continence enema procedure provides a successful outcome for some patients when incorporated into total anorectal reconstruction, provided that sepsis does not occur, thus avoiding permanent stoma formation. The combination of these procedures may represent an improvement in total anorectal reconstruction and warrants further clinical trial.

Use of Antegrade Continence Enema for the Treatment of Fecal Incontinence and Functional Constipation in Adults

“…four studies were excluded because the minimum age was <16 years. 33,39,42,43 Results from the various studies are presented according to the indication for the formation of aCe (see tables [1][2][3]. nine studies included patients with either fC or fi, 44-52 4 with fi alone, 37,53-55 and 5 with fC alone.…”

Importance of extrasphincteric mechanisms in the pathophysiology of faecal incontinence in adults with a history of anorectal anomaly

“…Two or more treatment modalities may be necessary to achieve continence, for example rectoplasty and antegrade continence enema stoma, sphincteroplasty or anal plug38. Other more advanced surgical techniques may also be considered39, 40. Alternatively, colostomy may offer a solution.…”

The Colorectal Development Unit: impact on functional outcome for the electrically stimulated gracilis neoanal sphincter

“…The evolution of reconstructive anorectal surgery is apparent in the appearance of additional procedures especially later in the CDU group, which reflects advances in assessment, understanding and treatment of faecal incontinence. Included within both groups were 20 patients following an APER or with anorectal atresia who had a formation of an Antegrade Continence Enema procedure (ACE) [37] or a Continent Colonic Conduit (CCC) [38] in conjunction with an ESGN for treatment of incontinence and evacuatory dysfunction as part of Total Anorectal Reconstruction [39]. In the CDU group there were six patients who underwent rectal augmentation [34] for rectal hypersensitivity in addition to the ESGN.…”