title: [Anal sphincter restoration using dynamic graciloplasty--results of 50 patients].
abstract: During the period from 1992 to 1998, 50 patients underwent anal sphincter restoration by dynamic graciloplasty for primary (n = 26) or secondary (n = 6) total anorectal reconstruction (TAR) following abdominoperineal rectal resection (APR) or acquired (n = 9) or congenital (n = 9) fecal incontinence, respectively. Forty-seven patients were operated on by a single-stage procedure using a modified technique for the muscle wrap ("split sling"). Muscle fiber transformation by controlled stimulation was achieved at the beginning of the learning curve within 8 weeks and in the meantime within 4 weeks. Rectal injury (n = 10) turned out to be the most serious postoperative complication and was observed mainly in patients following TAR (n = 8). As the most prominent functional problem constipation in patients following TAR hampered the postoperative functional result; however, this was overcome by regular enemas. An improvement in the continence status was observed in 80% of the patients treated for fecal incontinence, and following APR 66% of the patients had acceptable results without a permanent colostomy.
authors.affiliation: Ludwig Boltzmann Institut für chirurgische Onkologie, Donauspital im SMZ-Ost, Wien.
authors.forename: H R
authors.initials: HR
authors.lastname: Rosen
authors.forename: C
authors.initials: C
authors.lastname: Ausch
authors.forename: G
authors.initials: G
authors.lastname: Novi
authors.forename: G
authors.initials: G
authors.lastname: Zöch
authors.forename: W
authors.initials: W
authors.lastname: Feil
authors.forename: R
authors.initials: R
authors.lastname: Schiessel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000601:surgery*; D005242:Fecal Incontinence / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000379:methods; D016896:Treatment Outcome