Preliminary results of a multicentre trial of the electrically stimulated gracilis neoanal sphincter

Background: The electrically stimulated gracilis neoanal sphincter was init ially developed to treat refractory incontinence. Good early results were r eported from the two centres that pioneered the technique. The aim of this study was to assess the operation in a prospective multicentre setting. Methods: The procedure was performed on 64 patients from seven centres worl dwide and was performed in stages. All patients were evaluated clinically a nd manometrically before and after operation. Results: There was a high incidence of infective and hardware-related compl ications. At a median of 10 months following closure of the defunctioning s toma 56 per cent had experienced a good functional result. The major functi onal problems comprised evacuatory difficulties experienced by 25 per cent. Conclusion: The technique is effective in treating otherwise refractory inc ontinence. It is, however, a complex procedure and the morbidity rate may b e high, particularly during the learning curve, factors that necessitate ca reful patient selection.