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Development of procedures for fecal incontinence with sphincter atrophy by means of the cross-innervation between the pudendal nerve and the motor nerve to the lower limb

Research Project

Project/Area Number 10671214
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeSingle-year Grants
Section一般
Research Field Digestive surgery
Research InstitutionJICHI MEDICAL SCHOOL

Principal Investigator

SATO Tomoyuki  Jichi Medical School, Dept of Surgery, Josyu, 医学部, 助手 (50225976)

Co-Investigator(Kenkyū-buntansha) SEGAWA Satoru  Jichi Medical School, Dept of Surgery, Josyu, 医学部, 助手 (80254928)
KONISI Fumio  Jichi Medical School, Dept of Surgery, Professor, 医学部, 教授 (20142242)
Project Period (FY) 1998 – 2000
Project Status Completed (Fiscal Year 2000)
Budget Amount *help
¥3,200,000 (Direct Cost: ¥3,200,000)
Fiscal Year 2000: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 1999: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 1998: ¥2,000,000 (Direct Cost: ¥2,000,000)
Keywordspudendal nerve / innervation / fecal incontinence / surgery / 外肛門括約筋 / 便失禁 / 交叉吻合 / 末梢神経 / 分娩 / 骨盤底 / 神経伝導速度 / 抹消神経
Research Abstract

The aim of this study was to develop two kinds of procedures for the treatment of fecal in continence.
First experiment (cross nerve in nervation method) : On 14 sides of eight dogs, the transected proximal end of the nerve in nervating the biceps femoris muscle was microsurgically cross-transferred to the distal end of the transected pudendal nerve. The external anal sphincter was analyzed by electromyography and adenosine 5'-triphosphatase staining at three months after surgery. RESULTS : On 13 of 14 sides, the external anal sphincter was well preserved and the evoked potential was clearly recorded. CONCLUSIONS : The cross-nerve transfer procedure in a dog model was found to prevent muscular atrophy of the external anal sphincter when performed immediately after pudendal nerve transection.
Second experiment (end to side nerve anastomosis method) ; On the right side of each dog, the distal end of the transected nerve innervating the biceps femoris muscle was anastomosed to the perineural window of the pudendal nerve, where the epineurium was excised over a small area without injuring the funiculus. Reinnervation was studied 5 months after the operations. The left side of the dogs was used as a control. RESULTS : After end-to-side pudendal nerve anastomosis, the biceps femoris muscle contracted with the evoked potential in 5 dogs (71%) and demonstrated electric activity at rest in 3 dogs (43%), but there was no reflex activity after anal stimulation. Regenerated myelinated axons were observed in a cross section of the anastomosed nerve in 6 dogs. CONCLUSIONS : End-to-side pudendal nerve anastomosis is a promising technique for the creation of an anal sphincter in patients who have fecal in continence. The technique preserved the original external anal sphincter and created a skeletal muscle that was innervated by the pudendal nerve in 71% of the dogs studied

Report

(4 results)
  • 2000 Annual Research Report   Final Research Report Summary
  • 1999 Annual Research Report
  • 1998 Annual Research Report
  • Research Products

    (14 results)

All Other

All Publications (14 results)

  • [Publications] 佐藤知行 他: "Muscle change of anal sphincter reinervated by a normal somatic peripheral nerve."Disease of the Colon and Rectum. 42. 505-509 (1999)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2000 Final Research Report Summary
  • [Publications] 佐藤知行 他: "End-to-side pudendal nerve anastomosis for the creation of a new reinforcing sphincter in dogs."Surgery. 127. 92-98 (2000)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2000 Final Research Report Summary
  • [Publications] 佐藤知行 他: "Variation in the motor evoked potential latencies in the anal sphincter system with sacral magnetic stimulation."Disease of the Colon and Rectum. 43. 966-970 (2000)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2000 Final Research Report Summary
  • [Publications] 佐藤知行 他: "Physiological anorectal reconstruction with pudendal nerve anastomosis and a clonic S-pouch after abdominoperineal resection : Report of 2 successful cases."Surgery. 128(1). 116-120 (2000)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2000 Final Research Report Summary
  • [Publications] 佐藤知行 他: "Pelvic floor disturbance following childbirth : Vaginal delivery damages the upper levels of sphincter innervation."Dis Colon Rectum. (in press).

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2000 Final Research Report Summary
  • [Publications] Sato, F Konishi, K Kanazawa: "Muscle change after anal sphincter reinnervation by a normal somatic peripheral nerve."Dis Colon Rectum. 42. 505-509 (1999)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2000 Final Research Report Summary
  • [Publications] T Sato, F Konishi, K Kanazawa: "End-to-side pudendal nerve anastomosis for the creation of a new reinforcing sphincter in dogs."Surgery. 127. 92-8 (2000)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2000 Final Research Report Summary
  • [Publications] T Sato, F Konishi, K Kamazawa.: "V ariation in the motor evoked potential latencies in the anal sphincter system with sacral magnetic stimulation."Dis Colon Rectum. 43. 966-70 (2000)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2000 Final Research Report Summary
  • [Publications] T Sato, F Konishi, K Ueda, H Kashiwagi, K Kanazawa, H Nagai: "Physiological anorectal reconstruction with pudendal nerve anastomosis and a clonic S-pouch after abdominoperineal resection : Rerport of 2 successful cases."Surgery. Jul ; 128(1). 116-120 (2000)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2000 Final Research Report Summary
  • [Publications] T Sato, F Kornishi, H Minakami, N Nakatsubo, K Kanazawa, I Sato, K Itoh, H Nagai: "Pelvic floor disturbance following childbirth : Vaginal delivery damages the upper levels of sphincter innervation."Dis Colon Rectum. (in press).

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2000 Final Research Report Summary
  • [Publications] Sato T: "End-to-side pudendal nerve anastomosis for the creation of a new reinforcing sphincter in dogs."Surgery. 127. 92-98 (2000)

    • Related Report
      2000 Annual Research Report
  • [Publications] Sato T: "Variation in the motor evoked potential latencies in the anal sphincter system with sacral magnetic stimulation."Dis Colon Rectum. 43. 966-970 (2000)

    • Related Report
      2000 Annual Research Report
  • [Publications] 佐藤知行 他: "Muscle change of anal sphincter reinervated by a normal somatic peripheral nerve"Disease of the Colon and Rectum. 42. 505-509 (1999)

    • Related Report
      1999 Annual Research Report
  • [Publications] 佐藤 知行 他: "Muscle change of anal sphincter reinervated a normal somatic peripheral nerve." Disease of the Colon and Rectum. (in press). (1999)

    • Related Report
      1998 Annual Research Report

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Published: 1998-04-01   Modified: 2016-04-21  

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