Division of Colon and Rectal Surgery, Pennsylvania Hospital/Hospital of the University of Pennsylvania, University of Pennsylvania, 800 Walnut Street, 20th Floor, Philadelphia, PA 19106, USA.
Gastroenterol Clin North Am. 2013 Dec;42(4):815-36. doi: 10.1016/j.gtc.2013.09.006. Epub 2013 Nov 6.
The surgical approach to treating fecal incontinence is complex. After optimal medical management has failed, surgery remains the best option for restoring function. Patient factors, such as prior surgery, anatomic derangements, and degree of incontinence, help inform the astute surgeon regarding the most appropriate option. Many varied approaches to surgical management are available, ranging from more conservative approaches, such as anal canal bulking agents and neuromodulation, to more aggressive approaches, including sphincter repair, anal cerclage techniques, and muscle transposition. Efficacy and morbidity of these approaches also range widely, and this article presents the data and operative considerations for these approaches.
治疗粪便失禁的手术方法较为复杂。在优化的药物治疗失败后，手术仍然是恢复功能的最佳选择。患者的一些因素，如既往手术史、解剖结构紊乱和失禁程度，有助于为有经验的外科医生提供最合适的选择。有许多不同的手术管理方法，从更保守的方法，如肛门内括约肌填充剂和神经调节，到更激进的方法，包括括约肌修复、肛门环扎技术和肌肉移位。这些方法的疗效和发病率也差异很大，本文介绍了这些方法的数据和手术注意事项。
