Total anorectal reconstruction with an artificial bowel sphincter: Report of five cases with a minimum follow-up of 6 months

G. Romano, F. La Torre, G. Cutini, F. Bianco, P. Esposito

Research output: Contribution to journalArticle

Abstract

Background. The artificial bowel sphincter (Acticon ABS - American Medical Systems, Minneapolis, MN, USA) has been proposed as a treatment for patients with faecal incontinence. The good results achieved with this procedure encouraged us to utilize this device for reconstruction of patients who previously underwent an abdominoperineal resection (APR). Method. Between 1999 and 2000 we implanted the ABS in five patients undergoing an APR. One patient was male and four female, the mean age was 51.3 years. Three patients had been operated on for rectal cancer, one for rectal agenesia and one for a giant benign tumour of the pelvis. Results. The length of follow up ranged from 6 to 22 months. Manometry assessed a basal pressure with the ABS cuff inflated between 58 and 62.2 mmHg. All but one achieved a good grade of continence with a Wexner score range between 3 and 9. A certain degree of impaired evacuation occurred in two patients but, with adequate training, this improved and did not affect patient satisfaction. Conclusion. The ABS is a good option for reconstruction of patients previously treated with an APR. As compared to electrostimulated graciloplasty the ABS technique seems to be easier to perform and more acceptable for the patients, although the cost of the device is still high.

Original languageEnglish
Pages (from-to)339-344
Number of pages6
JournalColorectal Disease
Volume4
Issue number5
DOIs
Publication statusPublished - Sep 2002

Keywords

  • Abdominoperineal resection
  • Artificial bowel sphincter
  • Faecal incontinence

ASJC Scopus subject areas

  • Gastroenterology

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