Sofia C A, Rush B F, Koziol J, Rocko J M, Seebode J J
Department of Surgery, University of Medicine and Dentistry, New Jersey Medical School, Newark 07103-2757.
Am Surg. 1988 Jun;54(6):390-4.
An implantable device for establishing urinary continence has been developed and has received FDA approval (AS 800, American Medical Systems, Inc.). The authors have applied this device to the control of anal continence in dogs. Fifteen mongrel dogs underwent either anal sphincter disruption (7) or abdominal-perineal resection (8). Such animals have bowel movements almost hourly. In each case, the device was implanted at the time of surgery. In dogs with working cuffs and disabled or absent sphincters, continence was maintained in seven out of 15 animals for periods of 4-8 hours. After cuff activation, intraluminal cuff pressures of 50-70 cm of water achieved continence for a period of 8 hours. In animals sacrificed from 1 to 12 months after implantation, the device was found to be well tolerated by the body with minimal fibrosis of the mucosa or muscularis of the bowel. Complications observed in the same four out of 15 animals during the study period were infection, device extrusion, and device malfunction. Infection resolved with local wound care and antibiotics (3/4) and the device was successfully replaced in two out of four instances of extrusion. With cuffs of proper size and pressure, this appliance may be effective in the control of human anal incontinence via the establishment of continent perineal colostomies following an abdominal-perineal resection.
一种用于实现尿失禁控制的可植入装置已研发成功并获得美国食品药品监督管理局（FDA）批准（AS 800，美国医疗系统公司）。作者已将此装置应用于犬类肛门失禁的控制。15只杂种犬接受了肛门括约肌破坏手术（7只）或腹会阴切除术（8只）。这类动物几乎每小时都会排便。在每种情况下，该装置均在手术时植入。在袖带功能正常且括约肌功能丧失或缺失的犬只中，15只动物中有7只实现了4至8小时的控便。激活袖带后，50至70厘米水柱的腔内袖带压力可实现8小时的控便。在植入后1至12个月处死的动物中，发现该装置在体内耐受性良好，肠道黏膜或肌层仅有轻微纤维化。在研究期间，15只动物中有4只出现了并发症，包括感染、装置挤出和装置故障。3/4的感染通过局部伤口护理和抗生素治疗得到解决，在4例装置挤出病例中有2例成功更换了装置。使用尺寸和压力合适的袖带，该装置通过在腹会阴切除术后建立可控性会阴结肠造口术，可能对控制人类肛门失禁有效。
