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KMID : 0371319840260050683
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Journal of the Korean Surgical Society
1984 Volume.26 No. 5 p.683 ~ p.688
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Gracilis Muscle Transplant for Anal Incontinence
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신석우/Shin, Suk Woo
김승남/송영택/주상용/Kim, Seung Nam/Song, Young Tack/Choo, Sang Yong
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Abstract
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Anal incontinence which, although not menacing to life or even to ordinary good health, is extremly distressing to the patient in the discomfort and disturbance of function and the general wretchedness. The social embarrassment and ostracism of patient with anal stool and flatus incontinence can be devasting, no matter the age, sex or status of socioeconomic position.
Various conditions may be result in loss of control of the sphincter ani muscle. Direct injury to the muscle itself from accident or operation, damage to its nerve supply, and certain congenital anomalies from which either the muscle or its nerve supply is defective are the principal type of lesions which result in incontinence of feces.
For some of these conditions, efforts have been made in the past to repair the damaged muscle by suture of operation of various sorts.
We have recently done the transference of the gracilis muscle in two patients. The loss of anal sphincter control was due to operative trauma. In the first case, the anal sphincter dysfunction occured after pull-through operation for imperforate anus, and in the second case, the dysfunction occured after multiple operations for hemorrhoid.
Control of sphincter function was gained after gracilis.muscle transplantation and anal sphincter control was adequate for formed and hard stools but was partially inadequate for diarrheal stool.
However, the gain was good enough to warrant advocating the use of this technique for reconstruction of the anal sphincter in patient with anal incontinence due to operative trauma.
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