Experimental model of continent colostomy using rectus abdominis neosphincteroplasty

Détails

ID Serval
serval:BIB_EDE3DD0B364B
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Experimental model of continent colostomy using rectus abdominis neosphincteroplasty
Périodique
British Journal of Surgery
Auteur⸱e⸱s
Hetzer  F. H., Schwizer  W., Kuenzi  W., Demartines  N.
ISSN
0007-1323 (Print)
Statut éditorial
Publié
Date de publication
10/2003
Volume
90
Numéro
10
Pages
1273-9
Notes
Journal Article --- Old month value: Oct
Résumé
BACKGROUND: Use of dynamic myoplasty to create a continent stoma has produced promising results, but long-term stoma continence has not been achieved. The aim of the study was to establish and test a new model. METHODS: Three types of dynamic rectus abdominis sphincteroplasty around a colostomy and two conditioning protocols were tested in ten domestic pigs. Continence was assessed by means of conventional defaecography and neosphincter manometry after 8 and 12 weeks. The neosphincter muscle was studied histologically to assess the transformation of muscle type. RESULTS: Use of a distal rectus muscle sling surrounding the stoma by 270 degrees with a low-frequency conditioning protocol achieved a continent colostomy for more than 12 h on each of 5 consecutive days. The neosphincter had a 40-mm high-pressure segment with mean pressure of 74 (range 67-82) mmHg. The proportion of type I muscle fibres increased from 38 (range 32-42) to 74 (range 66-78) per cent after 12 weeks of conditioning. CONCLUSION: This pilot study demonstrated the feasibility of a continent stoma in an animal model with a dynamic rectus neosphincter. Long-term results should be confirmed in a larger series before use in humans can be considered.
Mots-clé
Animals Biopsy/methods Colostomy/*methods Electric Stimulation Fecal Incontinence/pathology/physiopathology/*surgery Female Manometry Pressure Rectus Abdominis/*transplantation *Surgical Flaps Swine
Pubmed
Web of science
Création de la notice
28/01/2008 9:53
Dernière modification de la notice
20/08/2019 17:15
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