ArticleInternational journal of colorectal disease2004
Surgical results and functional outcome after total anorectal reconstruction by double graciloplasty supported by external-source electrostimulation and/or implantable pulse generators: an 8-year experience.
Article in International journal of colorectal disease, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 14 citations in OpenAlex.
- Total anorectal reconstruction with gracilis muscle flap-assisted coloplasty following abdominoperineal resection: a case report.International journal of colorectal disease · 2026Article
- Application of Individualized Intensive Biofeedback Electrical Stimulation Therapy in the Recovery of Anal Function After Anal Reconstruction: A Case Report.Annals of medicine and surgery (2012) · 2025Article
- Current aspects and future prospects of total anorectal reconstruction--a critical and comprehensive review of the literature.International journal of colorectal disease · 2015Review
- Dynamic versus Adynamic Graciloplasty in Treatment of End-Stage Fecal Incontinence: Is the Implantation of the Pacemaker Really Necessary? 12-Month Follow-Up in a Clinical, Physiological, and Functional Study.Gastroenterology research and practice · 2015Article
- Surgical management for fecal incontinence.Clinics in colon and rectal surgery · 2014Review
- Sphincter-sparing surgery in patients with low-lying rectal cancer: techniques, oncologic outcomes, and functional results.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2014Review
- Use of the gluteus maximus muscle as the neosphincter for restoration of anal function after abdominoperineal resection.Techniques in coloproctology · 2013Article
- Modified dynamic gracilis neosphincter for fecal incontinence: an analysis of functional outcome at a single institution.World journal of surgery · 2010Article
- [Dynamic graciloplasty vs artificial bowel sphincter in the management of severe fecal incontinence].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2006Review
- Neosphincter surgery for fecal incontinence: a critical and unbiased review of the relevant literature.Surgery today · 2006Review
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsSurgical and functional results after abdominoperineal resection and total anorectal reconstruction by electrostimulated gracilis muscle transposition are still poorly documented. This study prospectively evaluated surgical and functional outcome over time in our patients. PATIENTS AND
methodsTwenty-three patients underwent abdominoperineal resection, coloperineal pullthrough, double graciloplasty, and loop abdominal stoma. Temporary external-source intermittent electrostimulation, biofeedback training, and selective delayed stimulator implantation to improve unsatisfactory results were carried out in the first 13 patients (1st series); thereafter (2nd series) the stimulator was implanted during graciloplasty. Surgical and oncological results were followed up in all patients. Functional results were evaluated in 16 patients who underwent abdominal stoma takedown, eight in each of the two series, by anomanometry (up to 1 year) and our own 0-20 scoring system (up to 8 years from initial surgery).
resultsThe rate of major and minor postoperative complications was 21.7% and 65%, respectively. Continuous electrostimulation proved effective on resting anal pressure. Early clinical assessments showed satisfactory functional results (considered as having a score < or =8) in all first-group patients, including five who had stimulator support, and in one-half of second-group patients. After impairment (at least 2 points) at 1 year in five patients, four of whom were from the first group, all functional results improved and became satisfactory from 5 years on (1st series) and from 4 years on (2nd series).
conclusionDespite marked morbidity the high rate of good results, which improved over time, suggests that total anorectal reconstruction is worth being performed as part of abdominoperineal resection in well-selected patients with a strong motivation to avoid a permanent colostomy.
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