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The Treatment of faecal incontinence following ileostomy takedown after rectal surgery for cancer

Attene, Federico and Scognamillo, Fabrizio and Xidas, Andreas and Serventi, Fernando and Trignano, Mario (2009) The Treatment of faecal incontinence following ileostomy takedown after rectal surgery for cancer. Journal of Nursing and Healthcare of Chronic Illness, Vol. 1 (3), p. 210-214. eISSN 1752-9824. Article.

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DOI: 10.1111/j.1752-9824.2009.01023.x

Abstract

Aim. The aim of this study was to assess the effectiveness of rehabilitative treatment of the pelvic floor on faecal incontinence after ileostomy take-down.
Background. Several conditions can induce surgeons to fashion an excluding ileostomy. In our experience 40% of patients subjected to ileostomy takedown refer faecal incontinence which becomes a chronic condition if not treated.
Design. Between 2006 and 2008 we observed fourteen patients with faecal incontinence after ileostomy takedown. Previous manometric assessment of the pelvic floor functionality they underwent rehabilitative treatment by electrostimulation of the anal sphincter.
Methods. The rehabilitation program was organised in 10 sessions each of 15 minutes. In each session a double electrode probe was introduced through the anus which is able to conduct electric impulses at a frequency of 75 Hz with an intensity of 15–50 mA and duration of 150 μs.
Results. All patients showed important clinical and manometric improvement. Three patients needed a second rehabilitative treatment with subsequent clinical resolution of faecal incontinence.
Conclusions. Improvement in all patients was found although the data are not statistically significant. Consideration of social and psychological implications of treatments is important. Patients need to acquire full control of their body and its functions. Considering that faecal incontinence is a pathology with high social costs it appears necessary to establish an effective and repeatable method of treatment. Electric stimulation seems to be the most adequate tool for this purpose.
Relevance to clinical practice. The standardisation of parameters in the treatment protocol of incontinence could allow to extend this therapy to a lot of colo-proctological units.

Item Type:Article
ID Code:3925
Status:Published
Refereed:Yes
Uncontrolled Keywords:Cancer, comfort, incontinence, protocol, rehabilitation, stoma
Subjects:Area 06 - Scienze mediche > MED/18 Chirurgia generale
Divisions:001 Università di Sassari > 03 Istituti > Patologia chirurgica
Publisher:Blackwell / Wiley
eISSN:1752-9824
Copyright Holders:Journal compilation © 2010 Blackwell Publishing
Deposited On:24 May 2010 09:59

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