title: Intersphincteric anal lipofilling with micro-fragmented fat tissue for the treatment of faecal incontinence: preliminary results of three patients.
abstract: Faecal incontinence is a very debilitating problem. Many techniques have been proposed to treat this condition, with controversial results. Autologous transplant of fat tissue is an established procedure used for the repair of tissue damage, and recent studies revealed the potentiality of tissue regeneration by human adipose-derived stem cells. We treated this condition with the injection, in the intersphincteric anal groove, of lipoaspirate processed by an innovative technology (Lipogems). The aim of the study was to evaluate the efficacy of Lipogems injection for the treatment of faecal incontinence. In February 2014 we treated 3 patients with faecal incontinence. The surgical procedure required three phases: lipoaspiration, processing of lipoaspirate with the Lipogems system, and injection of the obtained product in the intersphincteric anal groove. An accurate proctological examination followed at 1 week, 1 month and 6 months after treatment. Each patient reported an improved Wexner incontinence score at 1 month after the procedure. We observed an increase of resting pressure (by at least 10 mm Hg) and thickness of the internal anal sphincter respectively at ano-rectal manometry and by ultrasound (US) evaluation at the sixth month of follow-up. Our preliminary results are encouraging, but multicentric studies with longer follow-up are needed to validate this novel technique for treatment of faecal incontinence.
authors.affiliation: Department of General and Miniinvasive Surgery, University of Naples Federico II, Napoli, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cestaro
authors.affiliation: Department of General and Miniinvasive Surgery, University of Naples Federico II, Napoli, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: De Rosa
authors.affiliation: Department of General and Miniinvasive Surgery, University of Naples Federico II, Napoli, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Massa
authors.affiliation: Department of General and Miniinvasive Surgery, University of Naples Federico II, Napoli, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Amato
authors.affiliation: Department of General and Miniinvasive Surgery, University of Naples Federico II, Napoli, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Gentile
keywords: faecal incontinence; intersphincteric anal groove; lipofilling