title: Anorectal reconstruction by electrostimulated graciloplasty as part of abdominoperineal resection.
abstract: OBJECTIVE
  To report the outcomes of anorectal reconstruction by electrostimulated graciloplasty as part of abdominoperineal resection, on data prospectively collected over 10 years.
  
  
  METHODS
  Twenty-three abdominoperineal resections were associated to coloperineal pull through, double graciloplasty and loop abdominal stoma. Fifteen patients also received an implantable pulse generator, either for unsatisfactory result after external-source intermittent electrostimulation and biofeedback (five cases) or during graciloplasty (10 cases). Follow-up was to a maximum of 10 years. Functional outcome was followed up in sixteen patients who underwent stoma takedown.
  
  
  RESULTS
  Mean actuarial survival at 5 years was 72.3%. Satisfactory results (score < or =8) occurred in 75% of patients (three without and 13 with stimulator) in the early stages, decreasing to 57% at 1 year and gradually increasing up to 100% at 5 years and over.
  
  
  CONCLUSIONS
  Total anorectal reconstruction yields a good functional outcome over time. Thus, despite, and because of, a high complication rate and a great drain on resources, it should be considered a suitable procedure only for selected, strongly motivated patients.
authors.affiliation: Department of Surgical Sciences, General Surgery Clinic, University of Parma Medical School, Ospedale Maggiore, Via Gramsci 14, 43100 Parma, Italy. vincenzo.violi@unipr.it
authors.forename: V
authors.initials: V
authors.lastname: Violi
authors.forename: A S
authors.initials: AS
authors.lastname: Boselli
authors.forename: M
authors.initials: M
authors.lastname: De Bernardinis
authors.forename: R
authors.initials: R
authors.lastname: Costi
authors.forename: N
authors.initials: N
authors.lastname: Pietra
authors.forename: L
authors.initials: L
authors.lastname: Sarli
authors.forename: L
authors.initials: L
authors.lastname: Roncoroni
mesh_terms: D000368:Aged; D001003:Anal Canal / Q000601:surgery; D001676:Biofeedback, Psychology; D003125:Colostomy; D004599:Electric Stimulation Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative / Q000379:methods; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D012004:Rectal Neoplasms / Q000503:physiopathology / Q000601:surgery*; D012007:Rectum / Q000503:physiopathology / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome