Graciloplasty was performed at 43 patients with III stage of anal sphincter insufficiency. Program of preoperative preparation including therapeutic physical training and electrostimulation of gracilis muscle permitted to improve muscle's functional activity on 19.1%. Functional postoperative rehabilitation permitted to prevent the degenerative processes on displaced muscle and to improve the function of fecal continence. The good results after graciloplasty with functional rehabilitation has been achieved at 80%, satisfactory results at 8.6% patients.
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Visc Med
December 2024
Department of Surgery, Friedrich-Alexander-Universität Erlangen, Erlangen, Germany.
Background: Fecal incontinence (FI) is a frequent, often underestimated, health issue in adults. Its treatment is primarily nonsurgical. Only if conservative options fail to result in adequate symptom reduction should surgery be considered.
View Article and Find Full Text PDFTech Coloproctol
June 2023
Department of Colorectal Surgery, Pôle des Maladies de l'appareil Digestif (PMAD), Beaujon Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), University of Paris, 100 boulevard du Général Leclerc, 92110, Clichy, France.
Background: Management of recurrent rectovaginal fistula (rRVF) remains challenging despite the good results of graciloplasty reported in the literature. However, little is known about how to avoid a permanent stoma if graciloplasty fails. The aim of our study was to report the management of rRVF after failure of graciloplasty.
View Article and Find Full Text PDFTech Coloproctol
June 2023
Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Department of Colorectal Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd., Weston, FL, 33331, USA.
Background: Patients with refractory fecal incontinence symptoms can be treated with several surgical procedures including graciloplasty. Reported outcomes and morbidity rates of this procedure are highly variable. The aim of this study was to assess continence rate and safety of dynamic and adynamic graciloplasty.
View Article and Find Full Text PDFColorectal Dis
April 2023
Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida, USA.
Aim: Complex perineal fistulas (CPFs) are among the most challenging problems in colorectal practice. Various procedures have been used to treat CPFs, with none being a panacea. Our study aimed to assess the overall success and complication rates after gracilis muscle interposition in patients with CPF.
View Article and Find Full Text PDFColorectal Dis
January 2023
Department of Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.
Aim: Due to the introduction of a new implantable pulse generator (IPG), the Interstim II, patients with either a dynamic graciloplasty or an abdominally placed IPG for sacral neuromodulation could not undergo surgery to replace their IPG in the case of end of battery life. For these patients, the Medtronic Replacement Adaptor 09106 was created. This retrospective case series aims to study safety and feasibility of the Medtronic Replacement Adaptor 09106 in patients with abdominally placed IPGs.
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