C Brochard1,2, M Queralto3, P Cabarrot3, L Siproudhis4, G Portier5. 1. Service des Maladies de l'Appareil Digestif, CHU Pontchaillou, Université de Rennes 1, 2 rue Henri le Guillou, 35033, Rennes, France. charlene.brochard@chu-rennes.fr. 2. Services d'Explorations Fonctionnelles Digestives, CHU Pontchaillou, Université de Rennes 1, Rennes, France. charlene.brochard@chu-rennes.fr. 3. Service de Colo-proctologie, Clinique des Cèdres, Cornebarrieu, France. 4. Service des Maladies de l'Appareil Digestif, CHU Pontchaillou, Université de Rennes 1, 2 rue Henri le Guillou, 35033, Rennes, France. 5. Chirurgie Digestive, CHU Purpan, Université Paul Sabatier, Toulouse, France.
Abstract
BACKGROUND: The puborectoplasty in fecal incontinence (FI) has been described through retropubic approach. Here, we describe a puborectal sling placement through transobturator approach with a device used for vaginal vault prolapse and report long-term outcome at 5 years. METHODS: Six women with FI for whom usual treatments (including sacral nerve stimulation) have failed were enrolled in a pilot study. Cleveland Clinic Incontinence Score (CCIS) and FI quality of life (FIQL) were used to evaluate results. RESULTS: The median CCIS was significantly improved at 12 months (18.5 [15-20] vs 7.5 [4-20] in postoperative assessment; p = 0.037). The median FIQL was improved at 12 months (6.05 [5.6-7] vs 10.2 [5.6-12.5]; p = 0.0542). No adverse event was recorded except the distension of the device in one patient. Finally, at 5 years, 3 patients were improved, 1 had recurrence of FI symptoms (at 24 months) and 2 had no change. CONCLUSION: This technique is a minimally invasive surgical treatment and constitutes a new therapeutic option for FI in case of failure of conventional treatment.
BACKGROUND: The puborectoplasty in fecal incontinence (FI) has been described through retropubic approach. Here, we describe a puborectal sling placement through transobturator approach with a device used for vaginal vault prolapse and report long-term outcome at 5 years. METHODS: Six women with FI for whom usual treatments (including sacral nerve stimulation) have failed were enrolled in a pilot study. Cleveland Clinic Incontinence Score (CCIS) and FI quality of life (FIQL) were used to evaluate results. RESULTS: The median CCIS was significantly improved at 12 months (18.5 [15-20] vs 7.5 [4-20] in postoperative assessment; p = 0.037). The median FIQL was improved at 12 months (6.05 [5.6-7] vs 10.2 [5.6-12.5]; p = 0.0542). No adverse event was recorded except the distension of the device in one patient. Finally, at 5 years, 3 patients were improved, 1 had recurrence of FI symptoms (at 24 months) and 2 had no change. CONCLUSION: This technique is a minimally invasive surgical treatment and constitutes a new therapeutic option for FI in case of failure of conventional treatment.
Authors: A M Leroi; L Siproudhis; I Etienney; H Damon; F Zerbib; G Amarenco; V Vitton; J L Faucheron; C Thomas; F Mion; P Roumeguère; G Gourcerol; M Bouvier; K Lallouche; J F Menard; M Queralto Journal: Am J Gastroenterol Date: 2012-10-02 Impact factor: 10.864
Authors: Henri Damon; Anne Marie Schott; Xavier Barth; Jean Luc Faucheron; Laurent Abramowitz; Laurent Siproudhis; Marie-Odile Fayard; Cyrille Colin; Guy Valancogne; Véronique Bonniaud; François Mion Journal: Int J Colorectal Dis Date: 2008-05-28 Impact factor: 2.571
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