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Techniques chirurgicales de substitution sphinctérienne

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Book cover Incontinence anale de l’adulte

Part of the book series: La « Collection SNFCP » ((SNFCP))

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Résumé

Après échec des traitements conservateurs, la chirurgie peut être proposée aux patients souffrant d’incontinence sévère. La réparation sphinctérienne est la méthode de choix lorsqu’un defect sphinctérien est accessible à une réparation (comme dans les ruptures obstétricales). Bien que la morbidité soit acceptable, les résultats fonctionnels semblent se dégrader à long terme [1, 2]. La neurostimulation des racines sacrées, déjà évoquée, est une méthode plus récente qui offre des résultats prometteurs, mais tous les patients ne sont pas répondeurs au test. Les techniques plus complexes de substitution sphinctérienne constituent alors une alternative. Deux stratégies ont été proposées dans la littérature: la transposition musculaire et le remplacement prothétique. Leur mode d’action repose dans les deux cas sur la création d’une zone de haute pression par cerclage du canal anal. Ces méthodes s’adressent à des patients sélectionnés, volontaires, demandeurs d’une intervention conservant la continuité digestive en alternative à la stomie de dérivation, et compliants pour le suivi postopératoire.

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Authors and Affiliations

  1. Clinique de chirurgie digestive et endocrine, Institut des maladies de l’appareil digestif, CHU Nantes - Hôtel Dieu, 1, place A. Ricordeau, 44093, Nantes, France

    G. Meurette

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© 2013 Springer-Verlag Paris

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Meurette, G. (2013). Techniques chirurgicales de substitution sphinctérienne. In: Incontinence anale de l’adulte. La « Collection SNFCP ». Springer, Paris. https://doi.org/10.1007/978-2-8178-0456-9_10

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  • DOI: https://doi.org/10.1007/978-2-8178-0456-9_10

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-8178-0455-2

  • Online ISBN: 978-2-8178-0456-9

  • eBook Packages: MedicineMedicine (R0)

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