Perineal reconstruction with continent colostomy after the Miles operation

Since the beginning of the century, different surgical procedures have been employed to create new anal sphincters for a continent perineal colostomy after abdominal perineal anorectal resection for cancer. After a detailed review of all the currently employed surgical procedures, the authors present their experience with 15 cases treated by transposition of the gracilis muscles to the perineum. More than 50% of the operated patients had good functional results with complete continence for solid stools and sufficient control of the stimulus. Poor results are related to surgical complications or unexpected postsurgical diseases and cancer recurrence or metastases. This surgical procedure seems to be an interesting possibility for selected patients in the case of a permanent abdominal incontinent colostomy after the Miles operation.