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[New methods in the treatment of anorectal incontinence (author's transl)]
Insights
This study explored surgical methods for treating anal incontinence in children with anorectal agenesis. Novel surgical techniques show promise for improving continence, especially when combined with specialized training.
Area of Science:
- Pediatric Surgery
- Gastroenterology
Background:
- Anorectal agenesis frequently leads to anal incontinence in children, necessitating surgical intervention.
- Restoring continence in these patients presents significant reconstructive challenges.
Observation:
- Ten children with anal incontinence secondary to anorectal agenesis were treated between July 1979 and October 1980.
- Seven patients received free intestinal muscle grafts (Schmidt's method), with four utilizing a double-thickness graft modification.
- Three patients underwent a newly developed "fold-over" construction.
Findings:
- While preliminary and lacking statistical significance, the observed results indicate progress in achieving continence.
- Both the modified Schmidt's method and the "fold-over" technique demonstrated potential for improving anal incontinence outcomes.
Implications:
- These surgical approaches offer potential for significant improvement in the treatment of pediatric anal incontinence.
- Combining these methods with Engel's stool training may enhance long-term continence.
- Further research and combination with pelvic floor or external sphincter reconstructions could optimize permanent continence restoration.
Abstract:
Case reports of 10 children with anal incontinence, secondary to anorectal agenesis, who underwent operation for the restoration of continence in the period from July 1979 till October 1980. 7 of these children were given free grafts of intestinal muscle (Schmidt's method), 4 of which were double-thickness-grafts (our modification). 3 children were treated with a "fold-over" construction, newly developed by us. Even although the presented results, few in number and collected over a short period, do not, as yet, have any statistical significance, they do show progress in the problem of continence, so that these methods allows great improvement in the treatment of anal incontinence, particularly in conjunction with Engel's method of stool training. In order to achieve the best possible continence on a permanent basis, the methods described could be combined with other reconstructions of the pelvic floor or the external sphincter.