Dynamic rectus abdominis muscle sphincter for stoma continence: an acute functional study in a dog model.
نویسندگان
چکیده
Fecal stomal incontinence is a problem that continues to defy surgical treatment. Previous attempts to create continent stomas using dynamic myoplasty have had limited success due to denervation atrophy of the muscle flap used in the creation of the sphincter and because of muscle fatigue resulting from continuous electrical stimulation. To address the problem of denervation atrophy, a stomal sphincter was designed using the most caudal segment of the rectus abdominis muscle, preserving its intercostal innervation as well as its vascular supply. The purpose of the present study was to determine whether this rectus abdominis muscle island flap sphincter design could maintain stomal continence acutely. In this experiment, six dogs were used to create eight rectus abdominis island flap stoma sphincters around a segment of distal ileum. Initially, the intraluminal stomal pressures generated by the sphincter using different stimulation frequencies were determined. The ability of this stomal sphincter to generate continence at different intraluminal bowel pressures was then assessed. In all cases, the rectus abdominis muscle sphincter generated peak pressures well above those needed to maintain stomal continence (60 mmHg). In addition, each sphincter was able to maintain stomal continence at all intraluminal bowel pressures tested.
منابع مشابه
Use of the rectus abdominis muscle for abdominal stoma sphincter construction: an anatomical feasibility study.
Permanent fecal abdominal stomas significantly decrease quality of life. Previous attempts to create continent stomas by using dynamic myoplasty procedures have resulted in disappointing outcomes, primarily owing to denervation atrophy of the muscle flap that was used in the creation of the sphincter and because of muscle fatigue resulting from continuous electrical stimulation that is received...
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This study was conducted on 48 specimens of Rectus abdominis muscles for recognition and definition of passage and ramification of lower intercostal nerves. The main results of this study are as follows: 1- The seventh and eight intercostal nerves penetrated to posterior layer of the Rectus sheath while other intercostal nerves perforated to dorsal layer of internal oblique abdominis aponeurosi...
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متن کاملگزارش یک مورد هماتوم خودبخودی عضله رکتوس در حاملگی
Rectus sheath hematoma can be an unusual cause of abdominal mass that may present as an acute intra - abdominal problem. There are multiple causes and 1 with a tnrouqt: history, usually some precipitating factor can be identified. Hematoma is frequently due to rupture of Epigastric vesseles and only rarely to rupture of Rectus Abdominis muscle fibers. Misdiagnosis may result in the performance ...
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ورودعنوان ژورنال:
- Plastic and reconstructive surgery
دوره 107 2 شماره
صفحات -
تاریخ انتشار 2001