2002 Fiscal Year Final Research Report Summary
Research for reconstruction of anal function using electrical stimulation of transplanted gracilis muscle after resection of rectal cancer
| Project/Area Number |
11671285
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Digestive surgery
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| Research Institution | Kansai Medical University |
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Principal Investigator |
YOSHIOKA Kazuhiko Kansai Medical University Faculty of Medicine Assistant Professor, 医学部, 講師 (30166912)
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| Co-Investigator(Kenkyū-buntansha) |
TAKADA Hideho Kansai Medical University Faculty of Medicine Associate Professor, 医学部, 助教授 (30131444)
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| Project Period (FY) |
1999 – 2002
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| Keywords | cancer or the rectum / transplantation of the gracilis muscle / anal function / abdominal stoma |
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| Research Abstract |
1) Methodological establishment for physiological and anatomical studies
We have been able to prepare all equipments for physiological and anatomical studies for patients with anorectal functional disorders. We have established techniques for measurement of anorectal physiology and defecography. We measured anal pressure, anorectal inhibitory reflex, rectal sensation and threshold of anal mucosal sensation. Parameters for defecography were anorectal angle, anal canal length, pelvic floor descent and perineal descent.
2) Establishment of operative procedure and psychological assessments for patients with rectal cancer
We have carried out this new procedure in 8 patients with rectal cancer. We have also carried out graciloplasty using electrical stimulator in 4 patients with fecal incontinence. We have been able to establish the operative procedures without any operative death or major complications over the last 4 years. Informed consent has been obtained from all patients who wished to ha
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ve this operation. Psychological impact of having permanent abdominal stoma and possible disordered defecation after the operation were assessed using scenario based questionnaire in patients who was the candidates of this operation and those who had previously undergone abdominoperineal resection. The assessments revealed that although body image without having permanent abdominal stoma is clearly important for patients they also seemed to value good anal functional after this new operation.
3) Assessments of anal function
Clinical, physiological and anatomical assessments were carried out before and after the operation. We measured the functional parameters preoperatively. The same assessments were carried out before and after the electrical stimulation of the gracilis muscle and after closing the covering stoma. We have found that resting anal canal pressure increased after electrical stimulation. Clinical assessment revealed that 5 of 7 patients whose covering stoma had been closed achieved good functional results. Less
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