Rongen Mart-Jan G M, Uludag Ozenç, El Naggar Kadri, Geerdes Bas P, Konsten Joop, Baeten Cor G M I
Department of Surgery, University Hospital Maastricht, the Netherlands.
Dis Colon Rectum. 2003 Jun;46(6):716-21. doi: 10.1007/s10350-004-6645-7.
Graciloplasty has been used as a treatment for end-stage fecal incontinence since 1946. Electric stimulation with an implantable pulse generator has existed for 15 years. The gracilis muscle is wrapped around the anal canal and stimulated by intramuscular electrodes connected with an implantable pulse generator. Initial reports have been promising, but long-term results have not been presented to date.
Data of 200 consecutive patients with a follow-up of at least two years were analyzed in a prospective manner from 1986 until 1999.
The overall success rate was 72 percent. In patients with fecal incontinence caused by trauma, the rate was 82 percent. Once continent, patients remained continent after a median follow-up of 261 (standard deviation, 132) weeks. Median survival of the implantable pulse generator until battery expiration was 405 weeks. Disturbed evacuation remained a problem in 16 percent of all patients. Complications were frequent but treatable.
Dynamic graciloplasty is a good, cost-effective treatment for fecal incontinence with results lasting for a median of more than five years.
自1946年以来，股薄肌成形术一直被用作治疗终末期大便失禁的方法。植入式脉冲发生器进行电刺激已经有15年了。将股薄肌环绕肛管，并通过与植入式脉冲发生器相连的肌内电极进行刺激。初步报告显示前景良好，但迄今为止尚未公布长期结果。
对1986年至1999年间连续200例随访至少两年的患者的数据进行前瞻性分析。
总体成功率为72%。因创伤导致大便失禁的患者，成功率为82%。一旦实现控便，患者在中位随访261（标准差132）周后仍保持控便。植入式脉冲发生器直至电池耗尽的中位生存期为405周。在所有患者中，16%的人排便障碍仍然是个问题。并发症很常见，但可以治疗。
动态股薄肌成形术是一种治疗大便失禁的良好且具有成本效益的方法，其效果可持续中位时间超过五年。
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