Internal anal sphincter augmentation and substitution.
Internal anal sphincter augmentation and substitution.
复制标题
内部肛门括约肌扩大和替代。
DOI：
10.1093/gastro/gou004
复制
发表时间：
2014-05
影响因子：
3.6
通讯作者：
de la Portilla F
中科院分区：
文献类型：
--
作者：
de la Portilla F
人们越来越认识到表现为被动大便失禁的肛门内括约肌（IAS）功能障碍的重要性。这个问题可能在肛门括约肌切开术或微创痔疮手术后以及随着年龄的增长而出现。由于 IAS 折叠术的效果较差，而尿道周围填充剂在泌尿外科中的有益效果，这些材料已被开发用于治疗 IAS 功能障碍。这篇综述概述了据称的基本作用机制，定义了临床使用的材料、其部署方法、并发症和报告的结果。关于理想的药物或剂量和部署技术仍有很多未知之处，这只能通过强有力的、前瞻性的、随机的、对照试验来回答。在功能障碍或肌肉丧失的情况下，用于再生括约肌的自体干细胞的具体作用尚不清楚。
There is an increasing recognition of the importance of internal anal sphincter (IAS) dysfunction presenting as passive faecal incontinence. This problem may manifest after anal sphincterotomy or following the more minimally invasive operations for haemorrhoids, as well as with advancing age. Because of the poor results of IAS plication and the beneficial outcomes with peri-urethral bulking agents in urology, these materials have been developed for use in IAS dysfunction. This review outlines the basic purported mechanisms of action, defining the materials in clinical use, their methods of deployment, complications and reported outcomes. There is still much that is unknown concerning the ideal agent or the volume and the technique of deployment, which will only be answered by powerful, prospective, randomized, controlled trials. The specific role of autologous stem cells designed to regenerate the sphincters in cases of functional impairment or muscle loss is yet to be seen.