Gracilis muscle transposition for anal incontinence in children: long-term follow-up
Détails
ID Serval
serval:BIB_FE5F376720E5
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Institution
Titre
Gracilis muscle transposition for anal incontinence in children: long-term follow-up
Périodique
Journal of Pediatric Surgery
ISSN
0022-3468 (Print)
Statut éditorial
Publié
Date de publication
10/1991
Volume
26
Numéro
10
Pages
1219-23
Notes
Case Reports
Journal Article --- Old month value: Oct
Journal Article --- Old month value: Oct
Résumé
We report a series of 7 patients, aged 6.5 to 19 years (mean, 12.9), who have been treated for uncontrollable fecal incontinence since 1976: 5 had imperforate anus and multiple subsequent operative procedures, 1 had a low myelomeningocele with bi-sphincteric incontinence, and 1 had a traumatic destruction of the sphincter apparatus. A modified Pickrell procedure was performed, with the gracilis muscle transposed subcutaneously, without constructing a pulley through the median raphe as originally described. All patients were evaluated by anorectal manometry preoperatively and post-operatively. They were followed-up for a period of 0.5 to 12.5 years (mean, 4.4). All patients were continent at follow-up, with a normal defecation pattern and no enemas required. None of the patients had evidence of fibrosis of the muscle or anal canal, and tension in the transposed muscle was maintained. Voluntary contractions remain efficient in all cases. Age was thought to be an important factor: personal motivation and compliance with physiotherapy, essential for a good outcome, is unlikely to be present in the younger child. We conclude that the gracilis sling procedure is an excellent long-term alternative for total fecal incontinence when time and other therapeutic measures have failed.
Mots-clé
Adolescent
Adult
Age Factors
Anal Canal/physiology/*surgery
Anus, Imperforate/complications/surgery
Child
Fecal Incontinence/etiology/*surgery
Female
Follow-Up Studies
Humans
Male
Manometry
Meningomyelocele/complications
Muscles/*transplantation
Postoperative Complications
Rectum/physiology
Surgical Procedures, Operative/methods
*Thigh
Time Factors
Wounds and Injuries/complications
Pubmed
Web of science
Création de la notice
28/01/2008 10:12
Dernière modification de la notice
20/08/2019 17:28