Devesa J M, Vicente E, Enríquez J M, Nuño J, Bucheli P, de Blas G, Villanueva M G
Department of General Surgery, Hospital Ramón y Cajal, Universidad de Alcalá, Madrid, Spain.
Dis Colon Rectum. 1992 Apr;35(4):339-49. doi: 10.1007/BF02048111.
Since 1986, different procedures of gluteus maximus transposition have been performed, by one of the authors, in 10 patients with total anal incontinence not amenable to sphincter repair, due to congenital anomalies (four), sphincteric denervation (three) or after severe trauma (three). Variable degrees of long-lasting fecal control were obtained in all but one patient, with great improvement in six. Difficulties for achieving a closed anus without muscular tension of the neosphincter, together with the morbidity associated with anal wound infection, determined the reasons for the successive use of different techniques (Biström, Hentz, Schoamaker) until the authors, in 1990, designed a new procedure (Devesa). Although the reported experience with this technique described here is limited to only four patients, our impression is that the method is easier, has less morbidity, and achieves better short-term functional results, derived from a thick, tension-free neosphincter.
自1986年以来，本文作者之一对10例因先天性异常（4例）、括约肌去神经支配（3例）或严重创伤后（3例）而无法进行括约肌修复的完全性肛门失禁患者实施了不同的臀大肌转位手术。除1例患者外，其余患者均获得了不同程度的持久排便控制，其中6例有显著改善。在不造成新括约肌肌肉紧张的情况下实现肛门闭合存在困难，以及与肛门伤口感染相关的发病率，决定了先后使用不同技术（比斯特罗姆、亨茨、肖梅克）的原因，直到作者在1990年设计了一种新手术（德韦萨）。尽管此处报道的这项技术的经验仅限于4例患者，但我们的印象是，该方法更简便，发病率更低，且能从厚实、无张力的新括约肌获得更好的短期功能结果。
