Abstract:
BACKGROUND:Fecal incontinence is a common and severely disabling disorder. For patients with severe fecal incontinence, surgery may prove to be the only adequate treatment option. METHODS:This study reports on 43 patients that were treated with a prosthetic sphincter system between 2005 and 2009 in three coloproctological centres. MAIN OUTCOME MEASURES:complications, anal pressures before and after surgery, fecal continence score. RESULTS:The new artificial sphincter system significantly improves continence but leads to some complications in clinical practice. After implantation of the device, continence improved significantly (Keller & Jostarndt continence score 2.6 to 14.3 (P < 0.01)). With the band activated, resting pressure improved significantly as compared to baseline (10.7 mmHg vs. 66.1 mm Hg, P < 0.01). The same holds for anal sphincter squeeze pressure (32.2 mmHg versus 85.9 mm Hg, P < 0.01). Complications occurred in 21 patients (48.8%): 10 surgical and 13 technical. Two patients were affected by both technical and surgical problems. The median time of the occurrence was 3 months postop. In five patients difficulties arose within the first postoperative month leading to explantation of the device in three patients. 90% of complications occurred in the first year. CONCLUSIONS:The soft anal band of AMI (AAS), a new artificial anal sphincter, improves severe anal incontinence, but it must be regarded as a last treatment option to avoid a stoma.
journal_name
BMC Surgjournal_title
BMC surgeryauthors
Goos M,Baumgartner U,Löhnert M,Thomusch O,Ruf Gdoi
10.1186/1471-2482-13-45subject
Has Abstractpub_date
2013-10-08 00:00:00pages
45issn
1471-2482pii
1471-2482-13-45journal_volume
13pub_type
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