Diseases of the Colon & Rectum

, Volume 35, Issue 4, pp 339–349 | Cite as

Total fecal incontinence-a new method of gluteus maximus transposition: Preliminary results and report of previous experience with similar procedures

  • J. M. Devesa
  • E. Vicente
  • J. M. Enríquez
  • J. Nuño
  • P. Bucheli
  • G. de Blas
  • M. G. Villanueva
Original Contributions
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Abstract

Since 1986, different procedures of gluteus maximus transposition have been performed, by one of the authors, in 10 patients with total anal incontinence not amenable to sphincter repair, due to congenital anomalies (four), sphincteric denervation (three) or after severe trauma (three). Variable degrees of long-lasting fecal control were obtained in all but one patient, with great improvement in six. Difficulties for achieving a closed anus without muscular tension of the neosphincter, together with the morbidity associated with anal wound infection, determined the reasons for the successive use of different techniques (Biström, Hentz, Schoamaker) until the authors, in 1990, designed a new procedure (Devesa). Although the reported experience with this technique described here is limited to only four patients, our impression is that the method is easier, has less morbidity, and achieves better short-term functional results, derived from a thick, tension-free neosphincter.

Key words

Anal incontinence Gluteus maximus transposition Anorectal sphincter reconstruction 

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Copyright information

© American Society of Colon and Rectal Surgeons 1992

Authors and Affiliations

  • J. M. Devesa
    • 1
  • E. Vicente
    • 1
  • J. M. Enríquez
    • 1
  • J. Nuño
    • 1
  • P. Bucheli
    • 1
  • G. de Blas
    • 2
  • M. G. Villanueva
    • 3
  1. 1.Department of General Surgery, Colo-Rectal UnitHospital Ramón y Cajal, Universidad de AlcaláMadridSpain
  2. 2.Department of NeurophysiologyHospital Ramón y Cajal, Universidad de AlcaláMadridSpain
  3. 3.Department of PathologyHospital Ramón y Cajal, Universidad de AlcaláMadridSpain

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