Hamel Christian T, Marti Walter R
Universitätsspital Basel, Viszeral- und Gefässchirurgie, Spitalstrasse 21, 4031 Basel.
Ther Umsch. 2010 Jan;67(1):39-43. doi: 10.1024/0040-5930/a000008.
Fecal incontinence is underestimated in its prevalence. Therapeutic approaches vary; in mild-to-moderate cases, dietary changes and biofeedback sessions accompanied by specific medications can achieve a salutary effect. In cases of severe fecal incontinence, a conservative approach is ineffective and surgical intervention is indicated. However, several technical innovations and devices enable surgeons to offer patients reliable solutions for this functional disorder. While dynamic graciloplasty uses native muscle contraction ability to function as a new sphincter, the artificial bowel sphincter achieves the same goal by an inflatable cuff. A novel approach, which is suitable for selected patients with muscular and neurological defects alike, is the sacral nerve stimulator. It is crucial to choose the right procedure as determined by the underlying pathology.
大便失禁的患病率被低估了。治疗方法各不相同；在轻度至中度病例中，饮食改变、生物反馈治疗以及特定药物治疗可取得有益效果。在严重大便失禁的病例中，保守治疗方法无效，需进行手术干预。然而，多项技术创新和设备使外科医生能够为患者提供针对这种功能障碍的可靠解决方案。动态股薄肌成形术利用天然肌肉收缩能力来充当新的括约肌，而人工肛门括约肌则通过可充气袖带实现相同目的。一种适用于有肌肉和神经缺陷的特定患者的新方法是骶神经刺激器。根据潜在病理情况选择正确的手术方法至关重要。
