Skeletal Muscle-Derived Cell Implantation for the Treatment of Fecal Incontinence: A Randomized, Placebo-Controlled Study.

Background And Aims: Fecal incontinence (FI) improvement following injection of autologous skeletal muscle-derived cells has been previously suggested. This study aimed to test the efficacy and safety of said cells through a multicenter, placebo-controlled study, to determine an appropriate cell dose, and to delineate the target patient population that can most benefit from cell therapy.

Methods: Patients experiencing FI for at least 6 months were randomized to receive a cell-free medium or low or high dose of cells.

European Society of Coloproctology guidance on the use of mesh in the pelvis in colorectal surgery.

This is a comprehensive and rigorous review of currently available data on the use of mesh in the pelvis in colorectal surgery. This guideline outlines the limitations of available data and the challenges of interpretation, followed by best possible recommendations.

Ten-year Evaluation of a Large Retrospective Cohort Treated by Sacral Nerve Modulation for Fecal Incontinence: Results of a French Multicenter Study.

Objective: The aim of this study was to assess the effectiveness of sacral nerve modulation (SNM) in a large cohort of patients implanted for at least 10 years, quantify adverse event rates, and identify predictive factors of long-term success.

Summary Background Data: Few studies have evaluated the long-term success of SNM.

Methods: Data collected prospectively from patients implanted for fecal incontinence (FI) in 7 French centers between January 1998 and December 2008 were retrospectively analyzed.

Practical issues encountered while determining Minimal Clinically Important Difference in Patient-Reported Outcomes.

Background: Using a real dataset, we highlighted several major methodological issues raised by the estimation of the Minimal Clinically Important Difference (MCID) of a Patient-Reported Outcomes instrument. We especially considered the management of missing data and the use of more than two times of measurement. While inappropriate missing data management and inappropriate use of multiple time points can lead to loss of precision and/or bias in MCID estimation, these issues are almost never dealt with and require cautious considerations in the context of MCID estimation.

Efficacy and safety of sacral nerve modulation for faecal incontinence after pelvic radiotherapy.

Objective: To assess the efficacy and safety of sacral nerve modulation (SNM) in patients with faecal incontinence (FI) after pelvic radiotherapy in comparison with results of SNM for FI related to other conditions.

Methods: Prospectively collected data from patients who underwent SNM therapy between January 2010 and December 2015 at 7 tertiary colorectal units were reviewed retrospectively. Patients with FI following pelvic radiotherapy were identified and matched (1:2) for age and sex with 38 patients implanted over the same period for FI without previous radiotherapy.

Is Sacral Nerve Modulation a Good Option for Fecal Incontinence in Men?

Objective: The objective was to assess the efficacy and the safety of sacral nerve modulation (SNM) in men with fecal incontinence (FI) compared with those of SNM in women.

Method: Prospectively collected data from patients from seven tertiary colorectal units who underwent an implant procedure between January 2010 and December 2015 were reviewed retrospectively. Outcomes and surgical revision and definitive explantation rates were compared between men and women.

Long-term Outcome of Hirschsprung Disease: Impact on Quality of Life and Social Condition at Adult Age.

Background: Hirschsprung disease is a rare congenital disease typically requiring surgical treatment during childhood. Quality of life and social condition at adult age can be impaired by disease-specific sequelae.

Objective: This study aimed to assess the quality of life and social outcome of adult patients operated on for Hirschsprung disease during childhood.

Laparoscopic Roux-En-Y Gastric Bypass Versus Sleeve Gastrectomy on Pelvic Floor Disorders in Morbidly Obese Women: a Prospective Monocentric Pilot Study.

Background: Obesity is a well-known risk factor for female pelvic floor disorders (PFD). This study assessed the effects of bariatric surgery (BS) on pelvic organ prolapse symptoms (POPs) and urinary (UI) and anal incontinence (AI) in morbidly obese women undergoing either sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB).

Methods: Morbidly obese women undergoing BS from June 2016 to May 2017 were prospectively included.

Long-Term Outcome Following Implanted Pulse Generator Change in Patients Treated With Sacral Nerve Modulation for Fecal Incontinence.

Background: Long-term outcome of sacral nerve modulation (SNM) patients after implanted pulse generator (IPG) change for fecal incontinence (FI) is unknown. This study reported the outcome and long-term satisfaction after a change of an exhausted IPG, questioning the need to concurrently change the electrode and looking for factors involved in the maintenance of treatment efficiency.

Methods: Patients with fecal incontinence and with a Medtronic IPG implanted in a single center (2001-2016) were prospectively followed up.

Sacral Nerve Stimulation for Fecal Incontinence: How Long Should the Test Phase Be?

Background: Decision-making for pulse generator implantation for sacral nerve stimulation in the management of fecal incontinence is based on the results of a test phase. Its duration is still a matter of debate.

Objective: The purpose of this study was to determine whether an early positive response during the test phase could predict implantation of a permanent sacral nerve pulse generator.

Functional Results and Quality of Life Following Magnetic Anal Sphincter Augmentation in Severely Incontinent Patients.

Objective: Magnetic anal sphincter augmentation is a novel surgical option in the treatment of severe fecal incontinence. This study aimed to analyze functional results, quality of life, and satisfaction after implantation in the mid-term, and to identify factors associated with success of this new treatment.

Methods: All patients, who underwent magnetic anal sphincter augmentation procedure at a single center between December 2008 and January 2016, were consecutively included.

Is the Failure of Laparoscopic Peritoneal Lavage Predictable in Hinchey III Diverticulitis Management?

Background: Laparoscopic peritoneal lavage is an alternative to sigmoid resection in Hinchey III diverticulitis (generalized purulent peritonitis). The main limitation of laparoscopic peritoneal lavage is the higher rate of reoperation for persistent sepsis in comparison with sigmoid resection.

Objective: The purpose of the current study was to identify risk factors for laparoscopic peritoneal lavage failure in patients who have Hinchey III diverticulitis.

Long-term Experience of Magnetic Anal Sphincter Augmentation in Patients With Fecal Incontinence.

Background: Magnetic anal sphincter augmentation is a novel technique for the treatment of patients with fecal incontinence.

Objective: The current study reports the long-term effectiveness and safety of this new treatment modality.

Design: This was a prospective multicenter pilot study.

How to Size the Anal Canal Circumference When Implanting a Magnetic Anal Sphincter for Fecal Incontinence. Evolution and Update of a New Surgical Technique.

Introduction: Magnetic anal sphincter augmentation improves function and quality of life of patients with severe fecal incontinence substantially. Measuring the anal circumference exactly with a sizing tool represents a crucial step of the procedure because it determines the correct size and success of the definite implant.

Objective: This study aims to illustrate the consequent development of 3 different sizing models and the use of the recent sizing tool.

Exhausted implanted pulse generator in sacral nerve stimulation for faecal incontinence: What next in daily practice for patients?

Purpose: The efficacy of sacral nerve stimulation in faecal incontinence relies on an implanted pulse generator known to have a limited lifespan. The long-term use of sacral nerve stimulation raises concerns about the true lifespan of generators. The aim of the study was to assess the lifespan of sacral nerve stimulation implanted pulse generators in daily practice, and the outcome of exhausted generator replacement, in faecal incontinent patients.

Sacral nerve stimulation for faecal incontinence - efficacy confirmed from a two-centre prospectively maintained database.

Introduction: Sacral nerve stimulation (SNS) has been recognised as an effective treatment for faecal incontinence. Many unresolved questions could be answered when comparing large data-series from different centres providing prospective data.

Aim: To present data, from an international two-centre SNS prospective database (SNSPD) on functional outcome and management of surgical complications in patients treated with SNS for faecal incontinence.

Percutaneous endoscopic caecostomy for severe constipation in adults: feasibility, durability, functional and quality of life results at 1 year follow-up.

Background: The percutaneous endoscopic ceacostomy (PEC) for antegrade colonic enemas (ACE) has recently been proposed as a less invasive alternative to the Malone procedure in chronic constipated patients. Although the feasibility and safety of this innovative approach has been demonstrated, its functional results remain unknown. The aim of this study was to evaluate constipation symptoms and quality of life 1 year after the PEC placement.

Standardized surgical technique and dedicated operating room environment can reduce the operative time during robotic-assisted surgery for pelvic floor disorders.

Robotic-assisted surgery for pelvic floor disorders (PFD) meets the accepted standards for laparoscopic surgery. The aim of this study was to describe the technique and the impact of this standardized surgical technique and dedicated operating teams on the operative time for robotic-assisted laparoscopic ventral mesh rectopexy (RALVMR). Data from a prospective database were extracted for all patients who underwent RALVMR between January 2008 and May 2012 for multi-compartment PFD.

The magnetic anal sphincter: a new device in the management of severe fecal incontinence.

The authors aim to report the concept and technique of implantation and the first results of the clinical use of the magnetic anal sphincter (MAS) in the management of fecal incontinence (FI). The MAS device is designed to augment the native anal sphincter. The implant is a series of titanium beads with magnetic cores linked together with independent titanium wires.

Peristomal skin complications are common, expensive, and difficult to manage: a population based cost modeling study.

Background: Peristomal skin complications (PSCs) are the most common post-operative complications following creation of a stoma. Living with a stoma is a challenge, not only for the patient and their carers, but also for society as a whole. Due to methodological problems of PSC assessment, the associated health-economic burden of medium to longterm complications has been poorly described.

The artificial bowel sphincter: a single institution experience over a decade.

Objective: A report on the long-term results of a consecutive series of patients implanted with the Acticon Neosphincter.

Method: Data were reviewed from a prospective database. From May 1996 to Jan 2010, 52 patients (46 women), mean age 51.

The magnetic anal sphincter versus the artificial bowel sphincter: a comparison of 2 treatments for fecal incontinence.

Background: Fecal incontinence is a debilitating ailment, and surgery offers the only recourse for the patients in whom conservative treatment fails.

Objective: This study aims to report the first matched comparison between patients implanted with the magnetic anal sphincter and the artificial bowel sphincter.

Patients And Interventions: From December 2008 to June 2010, 10 female patients, median age 64.