Department of Surgery, Policlinico Umberto Primo, Sapienza University, Rome, Italy.
Department of General Surgery, Sant'Eugenio Hospital, Rome, Italy.
Colorectal Dis. 2020 Jan;22(1):80-85. doi: 10.1111/codi.14801. Epub 2019 Aug 16.
A new artificial anal sphincter placed into the intersphincteric space, SphinKeeper™, has recently been proposed to improve outcomes in the treatment of faecal incontinence (FI). We report our preliminary results with short-term follow-up, comparing preoperative and postoperative data after implant of SphinKeeper™ in patients suffering from FI.
All patients older than 18 years were included with FI of at least 6 months, incontinence episodes occurring more than once a week and resistance to other conservative treatments. Anorectal manometry, endoanal ultrasound, Cleveland Clinic FI Score, FI Quality of Life score and total number of episodes of FI per week were recorded preoperatively and at the end of the 6-month follow-up period.
Thirteen consecutive patients were treated with SphinKeeper™. No intra-operative nor postoperative complications were reported. Two cases of prosthesis extrusion occurred, and in one case an anterior dislocation was detected. Maximum resting pressure, total number of episodes of FI per week and Cleveland Clinic FI Score were improved after 6 months (P < 0.05).
SphinKeeper™ could be a minimally invasive procedure for FI with good postoperative outcomes. If these results are confirmed by studies with more patients and longer follow-up, it could be a first-line approach in FI.
最近提出了一种新的人工肛门括约肌,即 Sphinkeeper™,置于肛门括约肌间间隙,以改善粪便失禁(FI)的治疗效果。我们报告了短期随访的初步结果,比较了 Sphinkeeper™植入前后 FI 患者的术前和术后数据。
所有年龄大于 18 岁的患者均患有 FI 至少 6 个月,每周失禁发作超过一次,且对其他保守治疗有抵抗。术前和 6 个月随访期末记录肛门直肠测压、腔内超声、克利夫兰诊所 FI 评分、FI 生活质量评分和每周 FI 发作总次数。
13 例连续患者接受了 Sphinkeeper™治疗。无术中或术后并发症。有 2 例发生假体脱出,1 例发生前脱位。6 个月后,最大静息压、每周 FI 发作总次数和克利夫兰诊所 FI 评分均有所改善(P<0.05)。
Sphinkeeper™可能是 FI 的一种微创治疗方法,具有良好的术后效果。如果这些结果得到更多患者和更长随访时间的研究证实,它可能成为 FI 的一线治疗方法。