DOUBLE-GRACILIS ANORECTAL NEOSPHINCTER - TECHNIQUE OF RECONSTRUCTION AFTER NECROSIS OF THE DISTAL PART OF THE MUSCLES

PURPOSE: The aim of the present study is to demonstrate further recons truction of a double-gracilis anorectal neosphincter that had been des troyed because of a severe postoperative perineal infection, with necr osis of the distal part of the muscles. METHOD: Each residual gracilis muscle was split longitudinally into two branches, which surrounded t he neorectum, one posteriorly and the other one anteriorly, so as to p erform a perineorectal double sling. RESULT: Owing to a poor functiona l result, continence was achieved only by the support of an implantabl e pulse generator. CONCLUSION: This technique seemed to permit the opt imum use of the contractile potential of the residual gracilis muscles , which did not show evidence of defunction-related or ischemia-relate d fibrosis.