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2015 ; 2
(ä): 60
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Anal Sphincter Augmentation Using Biological Material
#MMPMID26636089
Alam NN
; Narang SK
; Köckerling F
; Daniels IR
; Smart NJ
Front Surg
2015[]; 2
(ä): 60
PMID26636089
show ga
INTRODUCTION: The aim of this review is to provide an overview of the use of
biological materials in the augmentation of the anal sphincter either as part of
an overlapping sphincter repair (OSR) or anal bulking procedure. METHODS: A
systematic search of PubMed was conducted using the search terms "anal bulking
agents," "anal sphincter repair," or "overlapping sphincter repair." Five studies
using biological material as part of an overlapping sphincter repair (OSR) or as
an anal bulking agent were identified. RESULTS: 122 patients underwent anal
bulking with a biological material. Anorectal physiology was conducted in 27
patients and demonstrated deterioration in maximum resting pressure, and no
significant change in maximum squeeze increment. Quality of life scores (QoLs)
demonstrated improvements at 6?weeks and 6?months, but this had deteriorated at
12?months of follow up. Biological material was used in 23 patients to carry out
an anal encirclement procedure. Improvements in QoLs were observed in patients
undergoing OSR as well as anal encirclement using biological material.
Incontinence episodes decreased to an average of one per week from 8 to 10
preoperatively. CONCLUSION: Sphincter encirclement with biological material has
demonstrated improvements in continence and QoLs in the short term compared to
traditional repair alone. Long-term studies are necessary to determine if this
effect is sustained. As an anal bulking agent the benefits are short-term.
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