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Chapter 30 Long-term Results After Fecal Incontinence Surgery
Table 30.9. Long-term results of dynamic graciloplasty with respect to etiology
Congenital incontinence (anal atresia)
417
Aut hor Year N F mean Follow-up Follow-up Success
Sonnino 1991 7 4 13 53 6–150 4/7
Baeten 1994 9 3 28 >24 4–78 5/9
Baeten et al. 1995 12 4 27 25 3–88 6/12
Geerdes 1996 13 32 4–104 7/13
Rosen 1998 6 19 3–53 6/6
Madoff et al. 1999 18 10 26 24 9/18
Baeten 2000 16 8 32 12 12–12 8/13
Rongen et al. 2003 28 45 15/28
Cumulative 109 60/109
Acquired incontinence (trauma, obstetric)
Aut hor Year N F mean Follow-up Follow-up Success
Williams 1991 20 16 3–38 12/20
Baeten et al. 1995 24 20 48 25 3–88 22/24
Geerdes 1996 34 32 4–104 31/34
Rosen 1998 4 19 3–53 3/4
Madoff et al. 1999 85 62 50 24 60/85
Baeten 2000 107 78 53 12 12–12 45/83
Rongen et al. 2003 98 45 80/98
Cumulative 372 253/348
age (mean) (range)
55%
age (mean) (range)
73%
See text for the definition of “success” and “improvement”.
but it was stated that both technical failures and complication rates were very high in
both types of treatment (Ortiz et al. 2003).
Details on the patient populations and the long-term results are given in the Tables 30.10 and 30.11. All studies included a mixture of incontinence etiologies. Longterm results with a median follow-up of 5 years or more are only available for the ABS
type AMS 800 (Wong et al. 1996; Christiansen et al. 1999; Parker et al. 2003), a device
that is no longer used. These three studies reported a cumulative success rate of 48%
(19/39), which was slightly worse than studies reporting results of the ABS Acticon
Neosphincter with a shorter mean follow-up of 19–30 months (see Table 30.11, cumulative success rate 55%,143/246). There are no long-term results regarding the ABS Acticon Neosphincter beyond 28 months, the success rate with a follow-up around
2 years being about 58%. Study results do not seem to deteriorate in the long run,once
the procedure has been completed successfully (Wexner et al. 2002; Rongen et al.
2003), but true long-term studies are not available yet.
418
Tilman T.Zittel
9/42 33/64 42/64
21% 52% 66%
30
Table 30.10. Long-term results of artificial bowel sphincter,type AMS 800 (mean follow-up at least 1 year)
age surgery (mean) (range) continence
Christiansen and Sparso 1992 12 9 Neuropathic 3/12 19 6–34 5/12 10/12
Lehur et al. 1996 13 9 44 Mixed 20 4–60 5/13 9/13 9/13
Wong et al. 1996 12 5 33 Mixed 58 30–76 3/12 9/12 9/12
Christiansen et al. 1999 17 11 46 Neuropathic 6/17 84 60–120 1/17 4/17 8/17
Parker et al. 2003 10 47 Mixed 91 29–143 6/10 6/10
Aut hor Yea r N F Mean Etiology Previous Follow-up Follow-up Full Success Improvement
Cumulative 64
Previous surgery,previous surgery for fecal incontinence.
Follow-up is given in months.
See text for the definition of “success” and “improvement”.
F female.
Chapter 30 Long-term Results After Fecal Incontinence Surgery
51/128 143/246 165/246
40% 58% 67%
419
26 2–39 6/18 6/18
25 7–49 6/16 10/16 11/16
age surgery (mean) (range) continence
2003 37 22 52 mixed 6/37 42 12/37 20/37 20/37
a
Table 30.11. Long-term results of artificial bowel sphincter,type Acticon Neosphincter (mean follow-up at least 1 year)
Parker et al. 2003 35 47 mixed 6–24 21/35 21/35
Aut hor Yea r N F Mean Etiology Previous Follow-up Follow-up Full Success Improvement
Lehur 1998 13 9 40 mixed 30 5–76 8/13 11/13
Lehur 2000 24 17 44 mixed 20 10–35 18/24 18/24
Malouf et al. 2000 18
Altomare 2001 28 28 58 mixed 15/28 19 7–41 14/28 21/28
Ortiz 2002 22 17 47 mixed 17/22 28 6–48 4/22 9/22 14/22
Devesa et al. 2002 53 35 46 mixed 27 7–55 29/53 37/53 43/53
Lehur et al. 2002 16 14 43 mixed
Michot
Cumulative 246
Previous surgery,previous surgery for fecal incontinence.
Follow-up is given in months.
See text for the definition of “success” and “improvement”.
F female.
Some patients with type AMS 800 included.
30
420
Tilman T.Zittel
30.11 Sacral Nerve Stimulation
Sacral nerve stimulation, first used by urologists to treat urinary incontinence,was introduced by Matzel et al. to treat fecal incontinence (Matzel et al. 1995). Sacral nerve
stimulation may be tested in incontinent patients with a morphologically intact anal
sphincter.In a prone position,sheathed needles are inserted into the sacral foramen of
S2, S3 and S4, and current is applied. The most efficient sacral nerve to stimulate the
anal sphincter,most often S3,is chosen for short-term chronic stimulation with an impulse generator. If percutaneous nerve stimulation for 6–10 days improves incontinence significantly and symptoms relapse upon ceasing temporary stimulation,a permanent impulse generator is implanted subcutaneously in the lower abdominal wall
or below the superficial fascia in the buttock.
The morbidity of this approach seems to be low, but technical problems such as
electrode migration occur and device removal due to intractable pain has been described (Ganio et al. 2001; Leroi et al.2001; Matzel et al.2001). In patients with fecal and
urinary incontinence, both can be improved by sacral nerve stimulation (Ganio et al.
2001; Leroi et al.2001).
Details on the patient populations and the long-term results are given in Table 30.12. There is a limited number of studies, with no study describing more than 16
patients, and most studies including a mixture of incontinence etiologies. Since there
is a test phase, which prohibits the permanent implantation of the impulse generator
in nonresponding patients,there is a high success rate,with almost all patients receiving a permanent stimulator having a significant improvement of fecal incontinence.
The longest mean follow-up is around 3 years, and these studies reported a significant
improvement of fecal incontinence in 23 of 26 patients (88% [Matzel et al. 2001,2003;
Kenefick et al.2002a]). There seems to be no deterioration of the initial improvement
of sphincter function up to 99 months after the implantation of the impulse generator
(Matzel et al.2003).
30.12 Quality of Life
Today,it is generally accepted that measuring the quality of life and taking the patient’s
perspective into account are indispensable for judging the outcome of surgical treatments. However, adequate tools to measure quality of life have been developed in recent years only, and it has become evident that unspecific quality-of-life measures do
not adequately reflect the influence of specific diseases on the quality of life. Therefore,
disease-specific quality-of-life measures had to be validated. For fecal incontinence,
Rockwood developed a Fecal Incontinence Severity Index (FISI [Rockwood et al.
1999]) and a Fecal Incontinence Quality of Life Scale (FIQL [Rockwood et al. 2000]),
which have both been endorsed by the American Society of Colon and Rectal Surgeons
(ASCRS).
come available only recently; accordingly, there are no quality-of-life data available regarding treatment outcomes after pelvic floor repairs. Limited data on quality of life
are available after anterior sphincteroplasty, which has been shown to improve the
FISI. Patient-rated and surgeon-rated FISI scores were identical and correlated with
the FIQL (Halverson and Hull 2002), and the degree of fecal incontinence correlated
negatively with the FIQL. Interestingly, incontinence to gas only did not decrease the
Chapter 30 Long-term Results After Fecal Incontinence Surgery
16/16 16/16
22/31 70/83 80/83
71% 84% 96%
421
19 5–37 5/5 5/5
age surgery (mean) (range) continence
32 6–60 4/4 4/4
Table 30.12. Long-term results of permanent sacral nerve stimulation (mean follow-up at least 1 year)
Malouf et al. 2000 5 5 59 mixed 1/5 16 3–26 4/5 5/5
Ganio et al. 2001 5 4 62
Ganio et al. 2001 16 12 51 mixed 6/16 16 3–45 12/16 16/16
Matzel et al. 2001 6 5 50 mixed 5/6 37 5–66 3/6 5/6
Aut hor Year N F Mean Etiology Previous Follow-up Follow-up Full Success Improvement
Rosen et al. 2001 16 50 neurologic 11 2/16 15 3–26
Kenefick et al. 2002 15 14 60 mixed 7/15 24 3–60 11/15 14/15 15/15
Kenefick et al. 2002 4 4 61 scleroderma 4
Matzel et al. 2003 16 14 54 mixed 8/16 33 3–99 11/16 12/16 14/16
Cumulative 83
Previous surgery,previous surgery for fecal incontinence.
Follow-up is given in months.
See text for the definition of “success” and “improvement”.
F female.
30
422
Tilman T.Zittel
quality of life compared to patients who were fully continent (Gutierrez et al. 2004). It
is also remarkable that although the rate of continent patients who underwent anterior sphincteroplasty a median of 10 years before decreased over time, only 6% of those
being fully continent at 10 years,74% of patients remained satisfied with the results of
the procedure (Gutierrez et al. 2004),supporting the importance of the patient’s view
of surgery.
Dynamic graciloplasty has been shown to improve the quality of life significantly.
The State-Trait Anxiety Inventory questionnaire and the Nottingham Health Profile,
although not disease-specific, both improved 1 year after a successful dynamic graciloplasty, with good correlation between the clinical results scored by the physician and
the patient (Baeten et al.1995; Adang et al.1998). In a prospective multicenter trial,the
SF-36 was improved in three of eight categories,and the Fecal Incontinence Type Specification in all ten categories,and the patients’ self-rating of bowel control significantly improved after 1 year (Baeten 2000; Wexner et al. 2002). Of the SF-36, the category
“social functioning” correlated with continence (Wexner et al.2002).
There are six reports describing an improved quality of life after the implantation
of an artificial bowel sphincter (ABS). In general, treatment-related quality-of-life
changes only refer to patients with a successful ABS implantation.Vaizey et al.investigated six women preoperatively and 3 months after an ABS implantation by the SF-36,
and found a significant improvement in two out of eight subscales (role emotional and
social function) (Vaizey et al. 1998). O’Brien et al. used a quality-of-life questionnaire
with 39 questions specifically constructed for patients with anal incontinence by
American Medical Systems (Vaizey et al. 1999).In ten patients with a successfully implanted device, the score significantly improved after device activation (O’Brien and
Skinner 2000). Sixteen patients were studied with the FIQL 6–12 months after ABS implantation,and the quality of life largely improved in all four domains explored (Lehur
et al. 2002). Devesa et al. retrospectively assessed 25 patients with the FIQL and observed significant improvements in all four domains as well.In addition, the postoperative increase of the anal resting pressure correlated with the coping/behavior subscale (Devesa et al. 2002). In a multicenter study, 59 patients completed the FIQL
12 months after device activation. A variety of incontinence symptoms impairing the
quality of life were improved postoperatively, but the scores of the four domains were
not given. In 44 patients, the health status questionnaire (HSQ) was completed
12 months after activation, and the HSQ significantly improved (Wong et al. 2002).
Finally, Parker et al. reported a significantly improved FIQL 12 months after device
activation in all four domains in 14 patients.However,of 35 devices implanted successfully in this study,only 17 were functional at 12 months,of which 14 were evaluated regarding quality of life (Parker et al. 2003). No quality-of-life data were reported for
those patients who had a failed ABS implantation in this study as well as in all the other studies cited, indicating that only patients with successful device implantation were
evaluated,which reflects a selection bias. Formally, quality-of-life data should be evaluated on an intention-to-treat basis,and these data are not available yet.
Limited data on quality of life are available after sacral nerve stimulation (SNS).Rosen et al. reported a significant improvement in all four domains of the FIQL in 12 patients 6 months after permanent implantation (Rosen et al. 2001). Matzel et al. found
an improvement of borderline significance in all four domains of the FIQL a median
of 18 months after device activation in four patients (Matzel et al.2003). In five patients
with permanent SNS and a median follow-up of 16 months, all patients showed an
overall improvement of the SF-36, but no statistical analysis was provided (Malouf et
al. 2000). In four patients with multiple sclerosis, the different subscales of the SF-36
Chapter 30 Long-term Results After Fecal Incontinence Surgery
showed a variable improvement, physical and social function being the most consistent. However, no actual data with statistical analysis were provided (Kenefick et al.
2002). In 14 patients with a median follow-up of 24 months, two domains of the SF-36
(role physical and social function) were significantly improved (Kenefick et al.2002).
Taken together, the available quality-of-life data stem from a very limited number of
patients.As reported for the artificial bowel sphincter,no quality-of-life data were reported for those patients that had a failed SNS implantation,again reflecting selection
bias.Although the study results are promising, further data collected on an intentionto-treat basis are needed.
30.13 Conclusion
The armamentarium of surgical procedures to treat fecal incontinence has increased
over the past decades. The interest in pelvic floor repairs seems to be fading, as the
functional results remain unsatisfactory. There are a few continuing publications on
anterior sphincteroplasty, and although the repaired sphincter and the functional results seem to deteriorate in the long term, it has to be kept in mind that around 75% of
patients were still satisfied with the result of the procedure after a median follow-up of
10 years (Gutierrez et al. 2004). Considering the low morbidity of the procedure,anterior sphincteroplasty remains an option in patients with an isolated sphincter defect.
Dynamic graciloplasty and the artificial bowel sphincter are complex and expensive procedures with a high morbidity and failure rate. Therefore, they should be reserved for carefully selected patients, and patients should be referred to specialized
centers.Both remain treatment options for younger, motivated patients with severe fecal incontinence. Sacral nerve stimulation might be the most thrilling advance in recent years, originally used for patients with severe fecal incontinence and no detectable anatomical sphincter defect,but now also being successfully tried in patients with
an anatomical sphincter defect or after an unsuccessful sphincter repair.The morbidity of the procedure is low, and the test phase of sacral nerve stimulation is a big advantage, as patients improving their continence during test stimulation have a more
than 90% chance of improving their continence with permanent stimulation. Followup of successful sacral nerve stimulation is available for up to 10 years now, with no decrease in efficacy surfacing thus far (Matzel et al.2003). The stimulating device is expensive, currently prohibiting its use on a large scale. However, as physicians’and the
society’s awareness of the detrimental effects of fecal incontinence rises,and considering that cardiac pacing or cardiac defibrillators are now standard care in selected patients, its costs may no longer be allowed as an argument to deny this treatment to a
patient in need, and the situation might change in the future, allowing more patients
to receive a costly treatment on the one hand,but dramatically increasing their quality
of life on the other.
Finally,there is a need for surgeons specializing in fecal incontinence treatment to
be able to offer the surgical treatment options named above. With aging societies, increasing awareness of incontinence problems and better-informed patients, the number of patients that seek treatment for fecal incontinence will rise. This chapter might
serve as an overview to give these patients a realistic judgment of the long-term result
that can be expected after surgical treatment for fecal incontinence.
423
30
424
Tilman T.Zittel
References
Adang EMM, Engel GL, Rutten FFH, Geerdes BP, Baeten CGMI (1998) Cost-effectiveness of dy-
namic graciloplasty in patients with fecal incontinence. Dis Colon Rectum 41 :725–734
Altomare DF, Dodi G, La Torre F, Romano G, Melega E,Rinaldi M (2001) Multicentre retrospec-
tive analysis of the outcome of artificial anal sphincter implantation for severe faecal incon-
tinence. Br J Surg 88 : 1481–1486
Athanasiadis S,Sanchez M, Nafe M (1994) Ergebnisse der anterioren Levator- und Externusplas-
tik bei der idiopathischen anorectalen Inkontinenz. Eine prospektive manometrische, elek-
tromyographische und radiologische Studie. Chirurg 65: 634–641
Athanasiadis S, Sanchez M, Kuprian A (1995) Langzeitergebnisse der posterioren Raffung nach
Parks. Eine elektromyographische,manometrische und radiologische Studie bei 31 Patienten.
Langenbecks Arch Chir 380 : 22–30
Athanasiadis S (1996) Chirurgie der primären Spincterinkontinenz. Chirurg 67:483–490
Bachoo P, Brazzelli M, Grant A (2003) Surgery for faecal incontinence in adults. Cochrane data-
base of systematic reviews, accession number 00075320–100000000–00152
Baeten C, Spaans F, Fluks A (1988) An implanted neuromuscular stimulator for fecal continence
following previously implanted gracilis muscle.Report of a case. Dis Colon Rectum 31:134–137
Baeten CG, Konsten J, Spaans F,Visser R, Habets AM,Bourgeois IM,Wagenmakers AJ, Soeters PB
(1991) Dynamic graciloplasty for treatment of faecal incontinence.Lancet 338 :1163–1165
Baeten CG, Konsten J, Heineman E, Soeters PB (1994) Dynamic graciloplasty for anal atresia.
J Pediatr Surg 29:922–924
Baeten CGMI, Geerdes BP, Adang EMM,Heineman E, Konsten J, Engel GL, Kester ADM, Spaans
F, Soeters PB (1995) Anal dynamic graciloplasty in the treatment of intractable fecal inconti-
nence. N Engl J Med 332 : 1600–1605
Baeten CGMI and the Dynamic Graciloplasty Therapy Study Group (2000) Safety and efficacy of
dynamic graciloplasty for fecal incontinence. Dis Colon Rectum 43 :743–751
Baig MK, Wexner SD (2000) Factor predictive of outcome after surgery for faecal incontinence.
Br J Surg 87: 1316–1330
Baxter NN, Rothenberger DA,Lowry AC (2003) Measuring fecal incontinence.Dis Colon Rectum
46: 1591–1605
Beck DE, Wexner SD (1998) Fundamentals of anorectal surgery. Saunders, London
Briel JW, de Boer LM, Hop WCJ, Schouten WR (1998) Clinical outcome of anterior overlapping
external anal sphincter repair with internal anal sphincter imbrication. Dis Colon Rectum 41 :
209–214
Buie WD, Lowry AC,Rothenberger DA, Madoff RD (2001) Clinical rather than laboratory assess-
ment predicts continence after anterior sphincteroplasty.Dis Colon Rectum 44: 1255–1260
Buttafuoco A,Keighley MRB (2000) Cost of pelvic floor repair for faecal incontinence.Dig Surg
17: 623–626
Chapman AE,Geerdes B, Hewett P et al (2002) Systematic review of dynamic graciloplasty in the
treatment of faecal incontinence.Br J Surg 89: 138–153
Chen AS, Luchtefeld MA, Senagore AJ et al (1998) Pudendal nerve latency. Does it predict out-
come of anal sphincter repair? Dis Colon Rectum 41: 1005–1009
Christiansen J, Lorentzen M (1987) Implantation of artificial sphincter for anal incontinence.
Lancet ii: 244–245
Christiansen J, Sparso B (1992) Treatment of anal incontinence by an implantable prosthetic anal
sphincter.Ann Surg 215 :383–386
Christiansen J, Rasmussen OO, Lindorff-Larsen K (1998) Dynamic graciloplasty for severe anal
incontinence.Br J Surg 85: 88–91
Christiansen J, Rasmussen OO, Lindorff-Larsen K (1999) Long-term results of artificial anal
sphincter implantation for severe anal incontinence.Ann Surg 230: 45–48
Cook TA,Mortensen NJ (1998) Management of faecal incontinence following obstetric injury.Br
J Surg 85: 293–299
Corman ML (1998) Colon and rectal surgery.Lippincott-Raven, Philadelphia
Deen KI, Oya M,Ortiz J, Keighley MRB (1993) Randomized trial comparing three forms of pelvic
floor repair for neuropathic faecal incontinence. Br J Surg 80: 794–798
Deen KI, Kumar D, Williams JG, Grant EA, Keighley MRB (1995) Randomized trial of internal
anal sphincter plication with pelvic floor repair for neuropathic fecal incontinence. Dis Colon
Rectum 38: 14–18
Chapter 30 Long-term Results After Fecal Incontinence Surgery
Devesa JM, Rey A,Hervas PL, Halawa KS,Larranaga I, Svidler L,Abraira V, Muriel A (2002) Arti-
ficial anal sphincter.Complications and functional results of a large personal series. Dis Co-
lon Rectum 45: 1154–1163
Engel AF, Kamm MA,Sultan AH,Bartram CI, Nicholls RJ (1994) Anterior anal sphincter repair in
patients with obstetric trauma. Br J Surg 81: 1231–1234
Fang DT, Nivatvongs S,Vermeulen FD,Herman FN, Goldberg SM,Rothenberger DA (1984) Over-
lapping sphincteroplasty for acquired anal incontinence.Dis Colon Rectum 27 :720–722
Ganio E, Masin A, Ratto C et al (2001) Short-term sacral nerve stimulation for functional anorec-
tal and urinary disturbances: results in 40 patients.Dis Colon Rectum 44 :1261–1267
Geerdes BP, Heineman E,Konsten J,Soeters PB, Baeten CG (1996) Dynamic graciloplasty.Com-
plications and management.Dis Colon Rectum 39 : 912–917
Gilliland R, Altomare DF, Moreira H et al (1998) Pudendal neuropathy is predictive of failure fol-
lowing anterior overlapping sphincteroplasty.Dis Colon Rectum 41 :1516–1522
Giordano P, Renzi A, Efron J et al (2002) Previous sphincter repair does not affect the outcome of
repeat repair. Dis Colon Rectum 45 :635–640
Gutierrez AB,Madoff RD,Lowry AC,Parker SC, Buie WD,Baxter NN (2004) Long-term results of
anterior sphincteroplasty. Dis Colon Rectum 47 :727–731
Henry MM, Simson JNL (1985) Results of postanal repair: a retrospective study. Br J Surg 72 :
S17–S19
Halverson AL, Hull TL (2002) Long-term outcome of overlapping anal sphincter repair. Dis Co-
lon Rectum 45: 345–348
Hool GH, Lieber ML, Church JM (1999) Postoperative anal canal length predicts outcome in pa-
tients having sphincter repair for fecal incontinence. Dis Colon Rectum 42 :313–318
Hullfish KL,Bovbjerg VE,Gibson J, Steers WD (2002) Patient-centered goals for pelvic floor dys-
function surgery: what is success,and is it achieved? Am J Obstet Gynecol 187 :88–92
Jameson JS,Speakman CTM, Darzi A,Chia YW, Henry MM (1994) Audit of postanal repair in the
treatment of fecal incontinence.Dis Colon Rectum 37 : 369–372
Jorge JMN,Wexner SD (1993) Etiology and management of fecal incontinence. Dis Colon Rectum
36: 77–97
Kalantar JS,Howell S,Talley NJ (2002) Prevalence of faecal incontinence and associated risk fac-
tors.An underdiagnosed problem in the Australian community? Med J Aust 176 :54–57
Karoui S,Leroi MA,Koning E et al (2000) Results of sphincteroplasty in 86 patients with anal in-
continence.Dis Colon Rectum 43 :813–820
Keighley MRB,Williams NS (1993) Surgery of the anus, rectum and colon. Saunders,London
Kenefick NJ,Vaizey CJ,Cohen RCG,Nicholls RJ,Kamm MA (2002a) Medium-term results of per-
manent sacral nerve stimulation for faecal incontinence. Br J Surg 89 : 896–901
Kenefick NJ,Vaizey CJ, Nicholls RJ,Cohen R, Kamm MA (2002b) Sacral nerve stimulation for fae-
cal incontinence due to systemic sclerosis. Gut 51 : 881–883
Konsten J, Rongen JM, Ogunbiyi OA et al (2001) Comparison of epineural or intramuscular nerve
electrodes for stimulated graciloplasty.Dis Colon Rectum 44 : 581–586
Körsgen S,Deen KI, Keighley MRB (1997) Long-term results of total pelvic floor repair for post-
obstetric fecal incontinence. Dis Colon Rectum 40 :835–839
Laurberg S, Swash M,Henry MM (1988) Delayed external sphincter repair for obstetric tear. Br J
Surg 75: 786–788
Le Blanc I, Michot F, Ducrotte P, Scotte M, Denis P, Teniere P (1993) In case of re-education fail-
ure, should postanal repair be the treatment of idiopathic fecal incontinence? Dig Surg 10:
39–42
Lehur P-A, Michot F, Denis P et al (1996) Results of artificial sphincter in severe anal inconti-
nence. Dis Colon Rectum 39 :1352–1355
Lehur PA, Glemain P, Bruley des Varannes S, Buzelin JM, Leborgne J (1998) Outcome of patients
with an implanted artificial anal sphincter for severe faecal incontinence. A single institution
report. Int J Colorectal Dis 13: 88–92
Lehur PA, Roig JV, Duinslaeger M (2000) Artificial anal sphincter: prospective clinical and man-
ometric evaluation.Dis Colon Rectum 43 :1100–1106
Lehur P-A, Zerbib F, Neunlist M, Glemain P, Bruley des Varannes S (2002) Comparison of quality
of life and anorectal function after artificial sphincter implantation. Dis Colon Rectum 45:
508–513
Leroi A-M, Michot F, Grise P, Denis P (2001) Effect of sacral nerve stimulation in patients with fe-
cal and urinary incontinence. Dis Colon Rectum 44 :779–789
425
30
426
Tilman T.Zittel
Londono-Schimmer EE, Garcia-Duperly R, Nicholls RJ et al (1994) Overlapping anal sphincter
repair for faecal incontinence due to sphincter trauma: five-year follow-up functional results.
Int J Colorect Dis 9: 110–113
Madoff RD, Rosen HR, Baeten CG et al (1999) Safety and efficacy of dynamic muscle plasty for
anal incontinence: lessons from a prospective, multicenter trial. Gastroenterology 116 :
549–556
Madoff RD, Baeten GMI, Christiansen J et al (2000) Standards for anal sphincter replacement.
Dis Colon Rectum 43: 135–141
Malouf AJ, Norton CS, Engel AF et al (2000a) Long-term results of overlapping anterior anal-
sphincter repair for obstetric trauma. Lancet 355: 260–265
Malouf AJ,Vaizey CJ,Nicholls RJ,Kamm MA (2000b) Permanent sacral nerve stimulation for fe-
cal incontinence.Ann Surg 232: 143–148
Malouf AJ,Chambers MG, Kamm MA (2001) Clinical and economic evaluation of surgical treat-
ments for faecal incontinence. Br J Surg 88 : 1029–1036
Matsuoka H, Mavrantonis C, Wexner SD, Oliveira L, Gilliland R, Pikarsky A (2000) Postanal re-
pair for fecal incontinence – is it worthwhile? Dis Colon Rectum 43 :1561–1567
Matzel KE, Stadelmaier U, Hohenfellner M, Gall FP (1995) Electrical stimulation of sacral spinal
nerves for treatment of faecal incontinence.Lancet 346 :1124–1127
Matzel KE, Madoff RD, LaFontaine LJ et al (2001a) Complications of dynamic graciloplasty. Dis
Colon Rectum 44: 1427–1435
Matzel KE,Stadelmaier U, Hohenfellner M, Hohenberger W (2001b) Chronic sacral spinal nerve
stimulation for fecal incontinence: long-term results with foramen and cuff electrodes. Dis
Colon Rectum 44: 59–66
Matzel KE, Bittorf B, Stadelmaier U,Hohenberger W (2003) Sakralnervenstimulation in der Be-
handlung der Stuhlinkontinenz. Chirurg 74: 26–32
Mavrantonis C,Wexner SD (1999) Stimulated graciloplasty for treatment of intractable fecal in-
continence.Dis Colon Rectum 42 : 497–504
Michot F, Costaglioli B, Leroi AM, Denis P (2003) Artificial anal sphincter in severe fecal inconti-
nence: outcome of prospective experience with 37 patients in one institution. Ann Surg 237:
52–56
Miller R, Orrom WJ, Cornes H, Duthie G, Bartolo DCC (1989) Anterior sphincter plication and
levatorplasty in the treatment of faecal incontinence. Br J Surg 76: 1058–1060
Nelson R, Norton N, Cautley E et al (1995) Community based prevalence of anal incontinence.
JAMA 274: 559–561
Nicholls RJ,Dozois RR (1997) Surgery of the colon and rectum. Churchill Livingston,New York
Nikiteas N, Korsgen S, Kumar D, Keighley MR (1996) Audit of sphincter repair. Factors associat-
ed with poor outcome. Dis Colon Rectum.39 :1164–1170
O’Brien PE, Skinner S (2000) The Acticon neosphincter artificial bowel sphincter in the treat-
ment of anal incontinence.Dis Colon Rectum 43 : 1213–1216
Oliveira L, Pfeifer J, Wexner SD (1996) Physiological and clinical outcome of anterior sphincter-
oplasty.Br J Surg 83:502–505
Ortiz H, Armendariz P, DeMiguel M, Ruiz MD,Alos R, Roig JV (2002) Complications and func-
tional outcome following artificial anal sphincter implantation.Br J Surg 89: 877–881
Ortiz H, Armendariz P, DeMiguel M, Solana A, Alos R, Roig JV (2003) Prospective study of arti-
ficial anal sphincter and dynamic graciloplasty for severe anal incontinence.Int J Colorectal
Dis 18: 349–354
Österberg A, Graf W,Holmberg A et al (1996) Long-term results of anterior levatorplasty for fe-
cal incontinence.Dis Colon Rectum 39 :671–675
Österberg A, Edebol Eeg-Olofsson, Graf W (2000) Result of surgical treatment for faecal incon-
tinence. Br J Surg 87 : 1546–1552
Parker SC, Spencer MP, Madoff RD, Jensen LL, Wong WD, Rothenberger DA (2003) Artificial
bowel sphincter.Long-term experience at a single institution. Dis Colon Rectum 46 :722–729
Parks AG (1975) Anorectal incontinence. Proc R Soc Med 68 :681–690
Parks AG, McPartlin JF (1971) Late repair of injuries of the anal sphincter. Proc R Soc Med 64 :
1187–1189
Pemberton J,Swash M, Henry MM (2002) The pelvic floor.Its function and disorders. Saunders,
London
Perry S, Shaw C, McGrother C et al (2002) Prevalence of faecal incontinence in adults aged 40
years or more living in the community. Gut 50: 480–484
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