Preliminary results of a multicentre trial of the electrically stimulated gracilis neoanal sphincter.
BACKGROUND
The electrically stimulated gracilis neoanal sphincter was initially developed to treat refractory incontinence. Good early results were reported from the two centres that pioneered the technique. The aim of this study was to assess the operation in a prospective multicentre setting.


METHODS
The procedure was performed on 64 patients from seven centres worldwide and was performed in stages. All patients were evaluated clinically and manometrically before and after operation.


RESULTS
There was a high incidence of infective and hardware-related complications. At a median of 10 months following closure of the defunctioning stoma 56 per cent had experienced a good functional result. The major functional problems comprised evacuatory difficulties experienced by 25 per cent.


CONCLUSIONS
The technique is effective in treating otherwise refractory incontinence. It is, however, a complex procedure and the morbidity rate may be high, particularly during the learning curve, factors that necessitate careful patient selection. Presented to the Association of Surgeons of Great Britain and Ireland in Bournemouth, UK, April 1997 and the European Council of Coloproctology in Edinburgh, UK, June 1997; and published in abstract form as Br J Surg 1997; 88(Suppl): 39 and Int J Colorectal Dis 1997; 12: 144
Mander
B J
BJ
Academic Department of Surgery, St Bartholomew's and the Royal London School of Medicine and Dentistry, UK.
Wexner
S D
SD
Williams
N S
NS
Bartolo
D C
DC
Lubowski
D Z
DZ
Oresland
T
T
Romano
G
G
Keighley
M R
MR
D000293:Adolescent; D000328:Adult; D000368:Aged; D001003:Anal Canal / Q000503:physiopathology*; D004599:Electric Stimulation Therapy / Q000379:methods*; D005242:Fecal Incontinence / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D009119:Muscle Contraction; D018482:Muscle, Skeletal / Q000637:transplantation*; D011446:Prospective Studies; D016896:Treatment Outcome