Experimental model of continent colostomy using rectus abdominis neosphincteroplasty

Details

Serval ID
serval:BIB_EDE3DD0B364B
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Experimental model of continent colostomy using rectus abdominis neosphincteroplasty
Journal
British Journal of Surgery
Author(s)
Hetzer  F. H., Schwizer  W., Kuenzi  W., Demartines  N.
ISSN
0007-1323 (Print)
Publication state
Published
Issued date
10/2003
Volume
90
Number
10
Pages
1273-9
Notes
Journal Article --- Old month value: Oct
Abstract
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.
Keywords
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
Create date
28/01/2008 9:53
Last modification date
20/08/2019 17:15
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