The Secca procedure for the treatment of fecal incontinence: definitive therapy or short-term solution.

The treatment of fecal incontinence by means of radiofrequency energy is based on the concept that collagen deposition and subsequent scarring may increase one's ability to recognize and retain stool and permit improved continence. The procedure is undertaken on an outpatient basis. Individuals may be considered candidates even if they have a potentially reparable defect since the technique does not limit one to the application of a subsequent procedure.

Self-expanding metallic stents in the management of lower gastrointestinal hemorrhage.

A case of an 82-year-old woman is reported who developed a lower gastrointestinal hemorrhage secondary to metastatic ovarian carcinoma to the colon. The bleeding, associated with an incomplete obstruction of the large bowel, was successfully treated with the endoscopic insertion of two self-expanding metal stents. A technique of stent placement is presented which differs from that previously reported, where both stents were via colonoscopy and without the use of fluoroscopy.

Safety and effectiveness of temperature-controlled radio-frequency energy delivery to the anal canal (Secca procedure) for the treatment of fecal incontinence.

Purpose: This multicenter study evaluated the safety and efficacy of radio-frequency energy delivery to the anal canal for the treatment of fecal incontinence.

Methods: Fifty patients at five centers were enrolled. All reported fecal incontinence at least once per week for three months, and medical and/or surgical management failed to help their symptoms.

Use of high-dose-rate brachytherapy in the management of locally recurrent rectal cancer.

Introduction: Locally recurrent rectal cancer is associated with poor quality of life and has justified aggressive surgical and adjuvant approaches to control the disease. This study was designed to evaluate the use of fractionated perioperative high-dose-rate brachytherapy in association with wide surgical excision (debulking). Our hypothesis is that this combined therapy can help control locally recurrent rectal cancer.

Hemorrhoids.

Technologic advances have contributed to numerous diverse approaches to the management of hemorrhoid disease over the past centuries. Better understanding of the pathophysiology and anatomy of the anal canal has also added to the increased success in the treatment of hemorrhoids. This article reviews the clinical and pathological aspects of hemorrhoid disease, emphasizing new therapeutic modalities.

The safety and efficacy of the artificial bowel sphincter for fecal incontinence: results from a multicenter cohort study.

Purpose: The aim of this trial was to evaluate the safety, efficacy, and impact on quality of life of the Acticon trade mark artificial bowel sphincter for fecal incontinence.

Methods: A multicenter, prospective, nonrandomized clinical trial was conducted under a common protocol. Patients were evaluated with anal physiology, endoanal ultrasonography, a fecal incontinence scoring system, fecal incontinence quality of life assessment, and overall health evaluation.

Placement of self-expanding metal stents for acute malignant large-bowel obstruction: a collective review.

Background: The purpose of this study was to review our experience with self-expanding metal stents as the initial interventional approach in the management of acute malignant large-bowel obstruction.

Methods: Twenty-six patients who underwent placement of colonic stents at our institution between June 1994 and June 2000 were identified and reviewed.

Results: In 14 patients, the stents were placed for palliation, whereas in 12, they were placed as a bridge to surgery.