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Implantation of ethylene vinyl alcohol copolymer for faecal incontinence management
Author(s) -
Stephens Jacqueline H.,
Rieger Nicholas A.,
Farmer K. Chip,
Bell Stephen W.,
Hooper Judy E.,
Hewett Peter J.
Publication year - 2010
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2010.05277.x
Subject(s) - medicine , vinyl alcohol , surgery , anal canal , sphincter , rectum , chemistry , organic chemistry , polymer
Purpose: The primary objectives of this trial were to evaluate the safety and feasibility of treatment and to gain a preliminary indication of the effectiveness of ethylene vinyl alcohol injections into the anal sphincters of faecally incontinent patients. Methods: Between April 2004 and February 2006, we conducted a prospective, single‐arm, procedure optimization study of ethylene vinyl alcohol injections in 21 subjects with well‐characterized faecal incontinence and an intact external anal sphincter at two Australian hospitals. Results: There was a significant decrease in the Cleveland Clinic Florida Faecal Incontinence Score (CCFFIS) ( P = 0.0005) and the Faecal Incontinence Severity Index score ( P = 0.005) after treatment. At 12 months post‐treatment, the mean CCFFIS had decreased by 37% ( P = 0.0021), and 47% of subjects had a ≥50% improvement in CCFFIS. There were significant improvements in embarrassment ( P = 0.0455) and coping/behaviour ( P = 0.0056) domains of the Faecal Incontinence Quality of Life. At 12 months, the mean anal canal length had increased by 29% ( P = 0.066), with 40% of patients demonstrating increases of 50% or more. There were no further improvements following retreatment. Conclusions: Ethylene vinyl alcohol injection into the anal intersphincteric plane is feasible and well tolerated. Improvement in faecal incontinence compared with baseline was seen. Retreating initial non‐responders was not successful.