Shatari T, Sugiyama Y, Teramoto T, Kitajima M, Minamitani H
Department of Surgery, School of Medicine, Keio University, Japan.
Int J Artif Organs. 1994 Apr;17(4):240-4.
For the reconstruction of anal function for fecally incontinent patients, it could be practicable to transpose the gracilis muscle around the anal canal, with electrical stimulation to maintain contraction. It is necessary to keep continuous tonus, so tetanic contraction or "summation" would be essential for fecal continence, with a stimulation which permits prolonged contraction. Transposition of the gracilis muscle around the rectum was performed in thirteen Japanese white male rabbits. The muscles of the conditioning group (n = 8) were stimulated at 10 Hz for 6 weeks before the procedure. By stimulation at 15 Hz, a low frequency to permit prolonged contraction, the neoanal pressure increased maximally to 134.2 +/- 55.6 cmH2O (mean +/- s.d.) in the conditioning group, and to 115.0 +/- 37.1 cmH2O in the non-conditioning group (n = 5) (N.S.). But, the basal pressure with stimulation rose 82.3 +/- 12.4% (mean +/- s.d.) of the increase in the conditioning group, while that of the non-conditioning group remained at resting pressure (p < 0.001). The conditioning made it possible for the rabbit's gracilis muscle to create anal pressure with a sufficient rise in the basal pressure at a frequency permitting prolonged contraction.
对于大便失禁患者的肛门功能重建，将股薄肌围绕肛管移位并进行电刺激以维持收缩可能是可行的。保持持续的张力很有必要，因此强直性收缩或“总和”对于大便失禁至关重要，需要一种能允许长时间收缩的刺激。在13只日本白色雄性兔子身上进行了股薄肌围绕直肠的移位手术。预处理组（n = 8）的肌肉在手术前6周以10Hz的频率进行刺激。通过以15Hz的频率刺激（这是一个允许长时间收缩的低频），预处理组的新肛门压力最大增加到134.2±55.6cmH₂O（平均值±标准差），未预处理组（n = 5）为115.0±37.1cmH₂O（无显著差异）。但是，刺激时的基础压力在预处理组中上升了增加量的82.3±12.4%（平均值±标准差），而未预处理组则保持在静息压力水平（p < 0.001）。预处理使得兔子的股薄肌能够在允许长时间收缩的频率下产生足够基础压力上升的肛门压力。
