Is fecal continence improved by nonstimulated gracilis muscle transposition?
OBJECTIVE
Gracilis muscle transposition for treatment of fecal incontinence gives variable results. Electric stimulation of transposed muscle recently brought this technique to the surface.


METHODS
We reviewed patients who had gracilis muscle transposition for fecal incontinence to determine who might benefit from electrostimulation.


RESULTS
Between 1979 and 1991, 22 patients underwent gracilis muscle transposition. At six months, 18 patients had improved continence, but 12 of the 18 were stable with time, and only 1 was fully continent. Six patients were candidates for electrostimulation; four had a contractile but fatigable transposed muscle, and two had ineffective transposed muscle with a gaping nonfibrotic anus.


CONCLUSIONS
Gracilis muscle transposition should be used first for severe incontinent patients, and electrostimulation should be used if there are unsatisfactory results.
Faucheron
J L
JL
Department of Alimentary Tract Surgery, Hôpital Saint-Antoine, Paris, France.
Hannoun
L
L
Thome
C
C
Parc
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D003125:Colostomy; D003131:Combined Modality Therapy; D003672:Defecation; D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D005242:Fecal Incontinence / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D009132:Muscles / Q000637:transplantation*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D012086:Reoperation; D013997:Time Factors