Abstract:
OBJECTIVE:To evaluate the outcome of artificial anal sphincter implantation for severe fecal incontinence in 37 consecutive patients operated on in a single institution from 1993 through 2001. SUMMARY BACKGROUND DATA:Implantation of an artificial anal sphincter is proposed in severe fecal incontinence when local treatment is unsuitable or has failed. The results of this technique have not been determined yet, and its place among the various operative procedures is still debated. METHODS:Artificial anal sphincters were implanted in 37 patients from 1993 through 2001. All patients had complete fecal incontinence and had failed to respond to medical treatment. Median duration of incontinence was 16 years. The causes of incontinence were sphincter disruption (19 patients), hereditary malformations (2 patients), and neurologic disease (16 patients). Six patients had had previous surgery for fecal incontinence. Assessment was made by physical examination (anal continence, rectal emptying) and anorectal manometry. RESULTS:In the first 12 patients, six devices had to be removed (50%); the cause of failure was found in all cases, and this allowed contraindications to be defined. Among the next 25 patients, 23 had an uncomplicated postoperative follow-up, and 5 developed seven complications: control pump change (n = 3), balloon migration (n = 1), and major rectal emptying difficulties in patients with obstructive internal rectal procidentia (n = 2). The artificial anal sphincter had to be removed definitively in three cases, representing the failure rate of this technique in the authors' experience (12%); two other devices had to be removed temporarily and the patients are awaiting reimplantation. In this latter group of 25 patients, 80% have an activated sphincter: continence for liquid stool is normal in 78.9%, continence for gas in 63.1%. Seven patients have rectal emptying difficulties, minor in five and major in two. Manometric studies showed mean pressures of 110 and 37 cm H(2)O with closed and open sphincter, respectively, with a mean duration of artificial sphincter opening of 128 seconds. CONCLUSIONS:The long-term functional outcome of artificial anal sphincter implantation for severe fecal incontinence is satisfactory; adequate sphincter function is recovered and the definitive removal rate is low. Good results are directly related to careful patient selection and appropriate surgical and perioperative management after a learning curve of the surgical team.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Michot F,Costaglioli B,Leroi AM,Denis Pdoi
10.1097/00000658-200301000-00008subject
Has Abstractpub_date
2003-01-01 00:00:00pages
52-6issue
1eissn
0003-4932issn
1528-1140journal_volume
237pub_type
杂志文章abstract:OBJECTIVE:To describe acute care length of stay (LOS) over all consecutive hospitalizations for the injury and according to level of care [intensive care unit (ICU), intermediate care, general ward], compare observed and expected LOS, and identify predictors of LOS. BACKGROUND:Prolonged LOS has important consequences ...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000000624
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:To determine if an aggressive surgical approach, with an increase in R0 resections, has resulted in improved survival for patients with gallbladder cancer. SUMMARY BACKGROUND DATA:Many physicians express a relatively nihilistic approach to the treatment of gallbladder cancer; consensus among surgeons regardi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000154118.07704.ef
更新日期:2005-03-01 00:00:00
abstract::The costs for elective cholecystectomies were measured 1955, 1965 and 1975. The average length of stay decreased by 25% between 1955 and 1965 and with the same amount between 1965 and 1975. In spite of these marked reductions in the average length of stay there was only a significant decrease in costs between 1955 and...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:
更新日期:1979-04-01 00:00:00
abstract:OBJECTIVE:To define the natural history of, and treatment strategy for, blunt traumatic internal carotid artery (ICA) pseudoaneurysms. BACKGROUND:The natural history and management of traumatic ICA pseudoaneurysms is controversial. METHODS:We retrospectively identified all traumatic ICA pseudoaneurysms diagnosed on h...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001158
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:To critically review the theoretical and actual risks and benefits of accelerated partial breast irradiation (APBI) after breast-conserving surgery. SUMMARY BACKGROUND DATA:Because of rapid evolution of radiation therapy techniques related to brachytherapy and three-dimensional conformal radiation therapy, A...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/01.sla.0000114219.71899.13
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVE:To investigate the use of coffee, caffeinated drinks, and caffeine tablets for pharmacological cognitive enhancement (CE) among surgeons. BACKGROUND:Surgeons have demanding workloads, and the resulting fatigue and concentration deficits can lead to medical errors. Some surgeons use substances that promote wa...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000000830
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:To investigate the correlation between in-hospital surgical delay before appendectomy for suspected appendicitis and the finding of perforated appendicitis in children. METHODS:All children undergoing acute appendectomy for suspected acute appendicitis at Karolinska University Hospital, Stockholm, Sweden fro...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001694
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:To compare outcomes of fenestrated (FEVAR) and open repairs of complex abdominal aortic aneurysms (cAAA). BACKGROUND:FEVAR has emerged as an alternative to open surgery for treating cAAA, but direct comparisons are limited. METHODS:We studied all repairs of intact or symptomatic cAAA in the Vascular Quality...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000003094
更新日期:2020-05-01 00:00:00
abstract::A review of the English literature reveals a total of 1,337 patients with choledochal cysts. Improved diagnostic techniques to visualize the biliary system are demonstrating an increasing number of unsuspected choledochal cysts in adult patients. Either choledochal cysts remain clinically silent until adulthood or may...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198105000-00018
更新日期:1981-05-01 00:00:00
abstract:OBJECTIVE:To determine the disease-free survival (DFS) and recurrence after the treatment of patients with rectal cancer with open (OPEN) or laparoscopic (LAP) resection. BACKGROUND:This randomized clinical trial (ACOSOG [Alliance] Z6051), performed between 2008 and 2013, compared LAP and OPEN resection of stage II/II...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1097/SLA.0000000000003002
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVE:To specifically target tumor angiogenesis by linking transgene expression of engineered mesenchymal stem cells to angiopoietin-1-induced differentiation. BACKGROUND:Mesenchymal stem cells (MSCs) have been used to deliver therapeutic genes into solid tumors. These strategies rely on their homing mechanisms on...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181fcb5d8
更新日期:2011-03-01 00:00:00
abstract::Glutaraldehyde treated human umbilical veins (Dardik Biograft) were used to bypass short segments of the femoral artery in 15 dogs and were compared to autogenous jugular veins placed in the contralateral femoral artery of each animal. All 15 autogenous jugular veins remained patent for the four month period of observ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197808000-00005
更新日期:1978-08-01 00:00:00
abstract::Despite the dramatically increased entry of women into general surgery and surgical subspecialties, traditionally male-dominated fields, there remains a gross under-representation of women in the leadership positions of these departments. Women begin their careers with fewer academic resources and tend to progress thr...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/SLA.0b013e3182111120
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVE:Because of rising costs and shrinking reimbursements, hospitals must continually find ways to improve efficiency and productivity. This study attempts to increase caseloads in ambulatory surgery operating rooms while maintaining patient satisfaction and safety. SUMMARY BACKGROUND DATA:In most hospitals, pati...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000193600.97748.b1
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVE:To investigate the incidence of nodal metastasis in a consecutive series of patients treated at the authors' institution with highly selective criteria, and to determine the impact that lymphatic mapping and sentinel node biopsy have on the detection of nodal metastases in this carefully selected patient popu...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.SLA.0000071564.27229.A9
更新日期:2003-06-01 00:00:00
abstract:OBJECTIVE:Comparison of minimal access retroperitoneal pancreatic necrosectomy (MARPN) versus open necrosectomy in the treatment of infected or nonresolving pancreatic necrosis. SUMMARY OF BACKGROUND DATA:Infected pancreatic necrosis may lead to progressive organ failure and death. Minimal access techniques have been ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e3181d96c53
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:To discuss the difficulties in dealing with infected or exposed ventral hernia mesh, and to illustrate one solution using an autogenous abdominal wall reconstruction technique. SUMMARY BACKGROUND DATA:The definitive treatment for any infected prosthetic material in the body is removal and substitution. When ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.SLA.0000055278.80458.D0
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:We aimed to determine the unbiased mortality rates for pancreatic surgery procedures at the national level through a comprehensive analysis of every inpatient case in Germany. SUMMARY OF BACKGROUND DATA:Several studies have proclaimed a general improvement of perioperative outcomes following pancreatic surge...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001693
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:To report on the long-term follow-up of a randomized clinical trial comparing pancreatic head resection according to Beger and limited pancreatic head excision combined with longitudinal pancreatico-jejunostomy according to Frey for surgical treatment of chronic pancreatitis. SUMMARY BACKGROUND DATA:Resectio...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.sla.0000157268.78543.03
更新日期:2005-04-01 00:00:00
abstract::Four hundred twenty-six patients with esophageal atresia with or without tracheoesophageal fistula have been primarily cared for at the University of Michigan Medical Center since Cameron Haight's initial experience with this entity. Over the period of observation, the incidence of new cases as well as the number of a...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198610000-00013
更新日期:1986-10-01 00:00:00
abstract::1016 Women were placed on estrogen support following hysterectomy and have been followed for a total of 14,318 patient/years. Support was principally conjugated estrogen with the customary dose 1.5 mg/day. The follow-up studies in this group of women shows a marked drop in deaths from all causes over those which might...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197705000-00010
更新日期:1977-05-01 00:00:00
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journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199706000-00017
更新日期:1997-06-01 00:00:00
abstract::Cadaver kidneys remain a scarce resource, yet single pediatric donor kidneys are underutilized at some centers. Between 1967 and 1984, 133 single pediatric and 318 adult donor cadaver transplants were performed. Patient and graft survival, renal function, and complications in adult recipients grouped by donor age were...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198608000-00011
更新日期:1986-08-01 00:00:00
abstract::Fifty-one adult patients were referred for surgical treatment during the time period from July 1980 to November 1985. The average age was 59 +/- 6 years (19-70 years). All patients had symptomatic ventricular tachycardia that was refractory to standard or experimental drug therapy. On the basis of patient condition, s...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198606000-00013
更新日期:1986-06-01 00:00:00
abstract:OBJECTIVE:To present the objectively assessed very long-term results of a prospective study of 149 patients with achalasia of the cardia who underwent Heller myotomy and posterior partial fundoplication. SUMMARY BACKGROUND DATA:Very few studies evaluate objectively the very long-term results to analyze whether the eff...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318159d7dd
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:Retrospective single-center studies have shown that diffusion-weighted magnetic resonance imaging (DWI) is promising for identification of patients with rectal cancer with a complete tumor response after neoadjuvant chemoradiotherapy (CRT), using certain volumetric thresholds. OBJECTIVE:This study aims to v...
journal_title:Annals of surgery
pub_type: 杂志文章,多中心研究
doi:10.1097/SLA.0000000000000909
更新日期:2015-12-01 00:00:00
abstract:PURPOSE:Though histological grade is known to have a major prognostic impact in metastatic mucinous appendiceal adenocarcinomas, the prognostic impact of grade in localized disease, and the validity of the American Joint Committee on Cancer AJCC Staging Manual 7th edition's decision to combine moderately and poorly dif...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e318269d680
更新日期:2013-06-01 00:00:00
abstract::In an effort to minimize the nutritional complications that follow resection of the pancreas for severe chronic pancreatitis, the authors have performed a duodenum-preserving total pancreatectomy in eight patients for severe unremitting pain requiring large doses of opiate analgesia. Good relief of pain was obtained i...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199111000-00007
更新日期:1991-11-01 00:00:00
abstract::The aim of this study was to compare the immediate postoperative results and the long-term outcome of ileal pouch-anal anastomosis in 94 patients with familial adenomatous polyposis to those in 758 patients with ulcerative colitis. Two colitis patients died after operation (0.3%), but no polyposis patients died. Overa...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198909000-00002
更新日期:1989-09-01 00:00:00
abstract:OBJECTIVE:Currently single-incision laparoscopic appendectomy (SIL-A) has become an option for treating appendicitis. The aim of this study was to evaluate the safety and feasibility of SIL-A compared with conventional laparoscopic appendectomy (CL-A) on a large experimental cohort. BACKGROUND:Several studies had repo...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001064
更新日期:2015-12-01 00:00:00