Improvement of anal sphincter function before preventive stoma closure: modern options
Abstract
Aim of investigation. To investigate options of improvement of anal sphincter function of defunctioning loop by BFT and tibial nerve stimulation.
Material and methods. Overall 23 patients with preventive stoma were included in original investigation. Diagnostic profilometry and sphincterometry were carried out. Treatment included BFT and tibial nerve stimulation for 10 days. Results. After treatment profilometry revealed statistically significant increase of mean resting pressure, while sphincterometry — at conation as well.
Conclusions. Muscular structures of the defunctioning anal sphincter respond to BFT and tibial nerve stimulation, increasing both tension and force of voluntary contractions.
About the Authors
O. Yu. Fomenko
Federal government-financed institution «Ryzhih State Scientific Center of Coloproctology» Ministry of healthcare of the Russian Federation
Russian Federation
Russian Federation
Fomenko Oksana Yu. — head of clinical pathophysiology laboratory
123423, Moscow, Salyama Adilya street, 2
S. I. Achkasov
Federal government-financed institution «Ryzhih State Scientific Center of Coloproctology» Ministry of healthcare of the Russian Federation
Russian Federation
Russian Federation
A. Yu. Titov
Federal government-financed institution «Ryzhih State Scientific Center of Coloproctology» Ministry of healthcare of the Russian Federation
Russian Federation
Russian Federation
D. V. Aleshin
Federal government-financed institution «Ryzhih State Scientific Center of Coloproctology» Ministry of healthcare of the Russian Federation
Russian Federation
Russian Federation
A. I. Kalashnikova
Federal government-financed institution «Ryzhih State Scientific Center of Coloproctology» Ministry of healthcare of the Russian Federation
Russian Federation
Russian Federation
S. V. Belousova
Federal government-financed institution «Ryzhih State Scientific Center of Coloproctology» Ministry of healthcare of the Russian Federation
Russian Federation
Russian Federation
D. V. Yegorova
Federal government-financed institution «Ryzhih State Scientific Center of Coloproctology» Ministry of healthcare of the Russian Federation
Russian Federation
Russian Federation
References
1. Gross E., Möslein G. Colonic pouch and other procedures to improve the continence after low anterior rectal resection with TME. Zentralbl Chir 2008; 133 (2):107-15.
2. Rasmussen O.O., Petersen I.K., Christiansen J. Anorectal function following low anterior resection. Colorectal Dis 2003; 5(3):258-61.
3. Ziv Y., Zbar A., Bar-Shavit Y., Igov I. Low anterior resection syndrome (LARS): cause, effect, and reconstructive considerations. Tech Coloproctol 2013; 17(2):151-62.
4. Kakodkar R., Gupta S., Nundy S. Low anterior resection with total mesorectal excision for rectal cancer: functional assessment and factorsaffecting outcome. Colorectal Dis 2006; 8(8):650-6.
5. Emmertsen K.J., Laurberg S. Rectal Cancer Function Study Group. Impact of bowel dysfunction on quality of life after sphincter-preserving resection for rectal cancer. Br J Surg 2013; 100(10):1377-87.
6. Bregendahl S., Emmertsen K.J., Lous J., Laurberg S. Bowel dysfunction after low anterior resection with and without neoadjuvant therapy for rectal cancer: a population-based cross-sectional study. Colorectal Dis 2013; 15(9):1130-9.
7. Luglio G., Masone S., Quarto G., Benassai G., Sollazzo V., Tarquini R., Celentano V., Giglio M., Bucci L. Functional results after TME: J-pouch vs straight coloanal anastomosis and role of neoadjuvant radiochemotherapy. Ann Ital Chir 2013; 84(5):571-4.
8. Lange M.M., den Dulk M., Bossema E.R., Maas C.P., Peeters K.C., Rutten H.J., Klein Kranenbarg E., Marijnen C.A., van de Velde C.J. Cooperative Clinical Investigators of the Dutch Total Mesorectal Excision Trial. Risk factors for fecal incontinence after rectal cancer treatment. Br J Surg 2007; 94(10):1278-84.
9. Chamlou R., Parc Y., Simon T., Bennis M., Dehni N., Parc R., Tiret E. Long-term results of intersphincteric resection for low rectal cancer. Ann Surg 2007; 246(6):916-21.
10. Tilney H.S., Tekkis P.P. Extending the horizons of restorative rectal surgery: intersphincteric resection for low rectal cancer. Colorectal Dis 2008; 10(1):3-15.
11. Scheer A.S., Boushey R.P., Liang S., Doucette S., O’Connor A.M., Moher D. The long-term gastrointestinal functional outcomes following curative anterior resection in adults with rectal cancer: a systematic review and meta-analysis. Dis Colon Rectum 2011; 54(12):1589-97.
12. De Buck van Overstraeten A., Wolthuis A.M., Vermeire S., Van Assche G., Laenen A., Ferrante M., Rutgeerts P., D’Hoore A. Long-term functional outcome after ileal pouch anal anastomosis in 191 patients with ulcerative colitis. J Crohns Colitis 2014; 8(10):1261-6.
13. Berndtsson I., Lindholm E., Oresland T., Borjesson L. Long-term outcome after ileal pouch anal anastomosis: function and health-related quality of life. Dis Colon Rectum 2007; 50(10):1545-52.
14. Bullard K.M., Madoff R.D., Gemlo B.T. Is ileoanal pouch function stable with time? Results of a prospective audit. Dis Colon Rectum 2002; 45(3):299-304.
15. Hahnloser D., Pemberton J.H., Wolff B.G., Larson D.R., Crownhart S., Dozois R.R. Results at up to 20 years after ileal pouch-anal anastomosis for chronic ulcerative colitis. Br J Surg 2007; 94(3):333-40.
16. Lundby L., Duelund-Jakobsen J. Management of fecal incontinence after treatment for rectal cancer. Curr Opin Support Palliat Care 2011; 5(1):60-4.
17. https://ru.wikipedia.org.
18. Du P., Zi S.M., Weng Z.Y., Chen W., Chen Y., Cui L. Biofeedback therapy for fecal incontinence in patients with mid or low rectal cancer after restorative resection. Zhonghua Wei Chang Wai Ke Za Zhi. 2010; 13(8):580-2.
19. Kim K.H., Yu C.S., Yoon Y.S., Yoon S.N., Lim S.B., Kim J.C. Effectiveness of biofeedback therapy in the treatment of anterior resection syndrome after rectal cancer surgery. Dis Colon Rectum. 2011; 54(9):1107-13.
20. Krivoborodov G.G., Mazo E.B., Moiseyev P.P., Sokolova A.A., Shkol’nikov M.Ye. Neurophysiologic study of tibial nerve stimulation prognosis at hyperactive urinary bladder. Rus med zhurn 2007; 29.
21. Mazo E.B., Krivoborodov G.G., Shkol'nikov M.Ye. Tibial nerve stimulation at hyperactive urinary bladder: Guidelines. М., 2007.15 p.
22. Frolov S.A., Poletov N.N., Kostarev I.V. et al., Tibial nerve stimulation at idiopathic and neurogenic forms of anal sphincter functional incompetence (review of the literature, pilot study). Koloproktologiya 2010; 2(32):19- 29.
23. Mentes B.B., Ytiksel O., et al. Posterior tibial nerve stimulation for faecal incontinence after partial spinal injury: preliminary report. Tech Coloproctol 2007; 11(2):115-9.
24. Vitton V., Damon H., et al. Transcutaneous posterior tibial nerve stimulation for fecal incontinence in inflammatory bowel disease patients: A therapeutic option? Inflamm Bowel Dis 2009; 15:402-5.
25. Govaert В. Pares D., Delgado-Aros S., et al. A prospective multicentre study to investigate percutaneous tibial nerve stimulation for the treatment of faecal incontinence. Colorectal Dis 2010; 12(12):1236-41.
26. Findlay J.M., Maxwell-Armstrong C. Posterior tibial nerve stimulation and faecal incontinence: a review. Int J Colorectal Dis 2011; 26(3):265-73.
27. Hotouras A., Thaha M., Boyle D., et al. Percutaneous tibial nerve stimulation (PTNS) improves functional outcomes in patients with faecal incontinence. Colorectal Dis 2011; 13(Suppl. 6):12.
28. Vitton V., Damon H., Roman S., Mion F. Transcutaneous electrical posterior tibial nerve stimulation for faecal incontinence: effects on symptoms and quality of life. Int J Colorectal Dis 2010; 25(8):1017.
29. Frolov S.A., Titov A.Y., Kostarev I.V., Poletov N.N., Dzhanaev Y.A. Efficiency of tibial neuromodulation at treatment of different forms faecal incontinence. Coloproctol 2013; 2(44)37-43.
Review
For citations:
Fomenko O.Yu., Achkasov S.I., Titov A.Yu., Aleshin D.V., Kalashnikova A.I., Belousova S.V., Yegorova D.V. Improvement of anal sphincter function before preventive stoma closure: modern options. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2015;25(5):77-83. (In Russ.)
Views:
201
Email this article 
