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Is fecal continence improved by nonstimulated gracilis muscle transposition?
J L Faucheron1, L Hannoun, C Thome
1Department of Alimentary Tract Surgery, Hôpital Saint-Antoine, Paris, France.
Purpose:
Gracilis muscle transposition for treatment of fecal incontinence gives variable results. Electric stimulation of transposed muscle recently brought this technique to the surface.
Methods:
We reviewed patients who had gracilis muscle transposition for fecal incontinence to determine who might benefit from electrostimulation.
Results:
Between 1979 and 1991, 22 patients underwent gracilis muscle transposition. At six months, 18 patients had improved continence, but 12 of the 18 were stable with time, and only 1 was fully continent. Six patients were candidates for electrostimulation; four had a contractile but fatigable transposed muscle, and two had ineffective transposed muscle with a gaping nonfibrotic anus.
Conclusion:
Gracilis muscle transposition should be used first for severe incontinent patients, and electrostimulation should be used if there are unsatisfactory results.