Minimally invasive surgery of faecal incontinence with autologous fat injection in children
- Authors: Pinigin A.G.1, Kuzmichev P.P.2, Marochko N.V.2, Ermolaeva V.A.3, Berezutskiy S.N.1
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Affiliations:
- Far Eastern State Medical University
- Institute for Advanced Training of Healthcare Professionals
- A.K. Piotrovich Children’s Regional Clinical Hospital
- Issue: Vol 11, No 1 (2021)
- Pages: 55-62
- Section: Original Study Articles
- URL: https://journal-vniispk.ru/2219-4061/article/view/123494
- DOI: https://doi.org/10.17816/psaic686
- ID: 123494
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Abstract
BACKGROUND: Faecal incontinence as a result of chronic functional constipation is a common problem among children. This condition is socially unacceptable. There is no clear consensus of a universally accepted pathogenesis, diagnostics, and optimal treatment for this condition. New methods of surgical treatment are necessary for accelerated normalization of the retaining faeces process and resolution of faecal incontinence in children.
THE AIM: The study was aimed to analyze the efficiency of the new minimally invasive surgery method of the anal sphincter complex restoring with autologous fat injection in children.
MATERIALS AND METHODS: The examined group included 31 patients aged from 4 to 17. The patients had chronic constipation combined with faecal incontinence more than once per week. All of them had no lesions of the anal sphincter and pelvic floor muscles. All patients underwent outpatient and inpatient treatment from 2016 to 2019. Patients underwent computed tomographic colonography with virtual colonoscopy in addition to general clinical methods, ultrasound and irrigoscopy. Minimally invasive surgery with autologous fat injection was performed to correct anorectal angle in the following conditions: ineffective nonsurgical treatment for 4-6 months, lengthening of puborectalis muscles, increasing of the anorectal angle more than 100 degrees.
RESULTS: We analyzed the complaints of the patients who underwent minimally invasive surgery. The study showed reducing of symptoms severity of chronic constipation up to complete normalization of defecation frequency after surgery (34.5%) in 3 months. The study also showed the complete absence of fecal incontinence in 3 months after this minimally invasive treatment in 83 per cent of children.
CONCLUSION: The retrorectal injection of autologous fat leads to fast resolution of faecal incontinence, normalization of defecation frequency and improvement of the life quality as a result.
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##article.viewOnOriginalSite##About the authors
Alexey G. Pinigin
Far Eastern State Medical University
Author for correspondence.
Email: alpinig@yandex.ru
ORCID iD: 0000-0002-9602-2858
SPIN-code: 9964-0705
Cand. Sci. (Med.)
Russian Federation, 35 Karla Marksa str., Khabarovsk, 680000Pavel P. Kuzmichev
Institute for Advanced Training of Healthcare Professionals
Email: kuzmichev.pavel@mail.ru
ORCID iD: 0000-0002-9168-9442
SPIN-code: 9932-1272
Dr. Sci. (Med.), Professor
Russian Federation, 35 Karla Marksa str., Khabarovsk, 680000Natalya V. Marochko
Institute for Advanced Training of Healthcare Professionals
Email: marochko66@mail.ru
Cand. Sci. (Med.)
Russian Federation, 35 Karla Marksa str., Khabarovsk, 680000Valentina A. Ermolaeva
A.K. Piotrovich Children’s Regional Clinical Hospital
Email: ermolaeva.valent@gmail.com
ORCID iD: 0000-0001-9078-9460
SPIN-code: 7298-7946
radiologist
Russian Federation, 35 Karla Marksa str., Khabarovsk, 680000Sergey N. Berezutskiy
Far Eastern State Medical University
Email: s79242147010b@yandex.ru
SPIN-code: 5966-4748
Cand. Sci. (Med.)
Russian Federation, 35 Karla Marksa str., Khabarovsk, 680000References
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