Willams N S, Hallan R I, Koeze T H, Pilot M A, Watkins E S
Surgical Unit, London Hospital, Whitechapel.
Ann R Coll Surg Engl. 1990 Mar;72(2):108-13.
Six patients incapacitating faecal incontinence, in whom conventional treatment had either failed or was contraindicated, were treated by a new technique. A neonanal sphincter was constructed by transposing the gracilis muscle around the anal canal. Chronic neuromuscular stimulation via an implanted electrical stimulator was then used in an attempt to convert the muscle to a slow twitch fatigue resistant muscle. Physiological measurements suggested that this conversion had begun, enabling the neosphincter to mount a sustained contraction. Five patients had their covering stomas closed, and continence was improved in all of them. However, one patient could not cope psychologically with the stimulator, and another patient was continent for long periods only when the neosphincter was used in conjunction with a silastic plug. This new technique may benefit selected patients with incontinence whose only alternative would be a permanent stoma.
六名患有严重大便失禁的患者，其传统治疗方法要么失败，要么存在禁忌，采用了一种新技术进行治疗。通过将股薄肌围绕肛管移位构建了新肛门括约肌。然后通过植入的电刺激器进行慢性神经肌肉刺激，试图将该肌肉转变为慢肌纤维抗疲劳肌肉。生理测量表明这种转变已经开始，使新括约肌能够进行持续收缩。五名患者关闭了造口，他们的控便能力均得到改善。然而，一名患者在心理上无法接受刺激器，另一名患者只有在新括约肌与硅橡胶塞联合使用时才能长时间保持控便。这项新技术可能会使某些大便失禁患者受益，这些患者唯一的选择原本是永久性造口。
