Service des Maladies de l'Appareil Digestif, CHU Pontchaillou, Université de Rennes 1, 2 rue Henri le Guillou, 35033, Rennes, France.
Services d'Explorations Fonctionnelles Digestives, CHU Pontchaillou, Université de Rennes 1, Rennes, France.
Tech Coloproctol. 2017 Apr;21(4):315-318. doi: 10.1007/s10151-017-1609-9. Epub 2017 May 3.
The puborectoplasty in fecal incontinence (FI) has been described through retropubic approach. Here, we describe a puborectal sling placement through transobturator approach with a device used for vaginal vault prolapse and report long-term outcome at 5 years.
Six women with FI for whom usual treatments (including sacral nerve stimulation) have failed were enrolled in a pilot study. Cleveland Clinic Incontinence Score (CCIS) and FI quality of life (FIQL) were used to evaluate results.
The median CCIS was significantly improved at 12 months (18.5 [15-20] vs 7.5 [4-20] in postoperative assessment; p = 0.037). The median FIQL was improved at 12 months (6.05 [5.6-7] vs 10.2 [5.6-12.5]; p = 0.0542). No adverse event was recorded except the distension of the device in one patient. Finally, at 5 years, 3 patients were improved, 1 had recurrence of FI symptoms (at 24 months) and 2 had no change.
This technique is a minimally invasive surgical treatment and constitutes a new therapeutic option for FI in case of failure of conventional treatment.
经耻骨后入路的耻骨直肠肌成形术已被用于治疗粪便失禁（FI）。本文介绍了一种通过经闭孔途径放置耻骨直肠吊带的方法，该方法使用了一种用于阴道穹窿脱垂的装置，并报告了 5 年的长期结果。
6 名 FI 患者（包括骶神经刺激治疗失败）参与了本研究。采用克利夫兰失禁评分（CCIS）和 FI 生活质量（FIQL）评估结果。
术后 12 个月，CCIS 中位数显著改善（18.5[15-20]vs 7.5[4-20]；p=0.037）。FIQL 中位数在术后 12 个月时也得到改善（6.05[5.6-7]vs 10.2[5.6-12.5]；p=0.0542）。除 1 例患者出现装置膨胀外，无其他不良事件发生。最后，5 年后，3 例患者得到改善，1 例出现 FI 症状复发（24 个月），2 例无变化。
该技术是一种微创外科治疗方法，对于常规治疗失败的 FI 是一种新的治疗选择。
