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Implantation of autologous muscle-derived stem cells in treatment of fecal incontinence: results of an experimental pilot study.

Romaniszyn M, Rozwadowska N, Malcher A, Kolanowski T, Walega P, Kurpisz M - Tech Coloproctol (2015)

Bottom Line: In manometric examinations 18 weeks after implantation, squeeze anal pressures and high-pressure zone length increased in all patients, with particularly significant sphincter function recovery in five patients (55.6 %).The remaining four patients (44.4 %) still described their continence as better than before implantation and retained satisfactory functional examination parameters.Implantation of autologous myoblasts gives good short-term results not only in a subjective assessment, but also in objective functional tests.

View Article: PubMed Central - PubMed

Affiliation: 3rd Department of General Surgery, Jagiellonian University Medical College, ul. Pradnicka 35-37, 31-202, Kraków, Poland. m.romaniszyn@mp.pl.

ABSTRACT

Background: The aim of this study is to present results of the implantation of autologous myoblasts into the external anal sphincter (EAS) in ten patients with fecal incontinence.

Methods: After anatomical and functional assessment of the patients' EAS, a vastus lateralis muscle open biopsy was performed. Stem cells were extracted from the biopsy specimens and cultured in vitro. Cell suspensions were then administered to the EAS. Patients were scheduled for follow-up visits in 6-week intervals. Total follow-up was 12 months.

Results: All biopsy and cell implantation procedures were performed without complications. Nine of the patients completed a full 12-month follow-up. There was subjective improvement in six patients (66.7 %). In manometric examinations 18 weeks after implantation, squeeze anal pressures and high-pressure zone length increased in all patients, with particularly significant sphincter function recovery in five patients (55.6 %). Electromyographic (EMG) examination showed an increase in signal amplitude in all patients, detecting elevated numbers of propagating action potentials. Twelve months after implantation two patients experienced deterioration of continence, which was also reflected in the deterioration of manometric and EMG parameters. The remaining four patients (44.4 %) still described their continence as better than before implantation and retained satisfactory functional examination parameters.

Conclusions: Implantation of autologous myoblasts gives good short-term results not only in a subjective assessment, but also in objective functional tests. It seems that this promising technology can improve the quality of life of patients with fecal incontinence, but further study is required to achieve better and more persistent results.

No MeSH data available.


Related in: MedlinePlus

Comparison of electromyography signal amplitude (IARV) in Hz before implantation in patients who did and did not achieve satisfactory results
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Fig13: Comparison of electromyography signal amplitude (IARV) in Hz before implantation in patients who did and did not achieve satisfactory results

Mentions: Twelve months after implantation, a deterioration of continence was reported by two of the six patients who achieved good results at 18 weeks. This was also reflected in the deterioration of manometric (BAP, SAP, HPZL) and EMG parameters (Figs. 5, 6, 7, 10, 11). Nevertheless, mean values were still significantly better than before the implantation. The remaining four patients (44.4 %) continued to have satisfactory results after 12 months, with reduction in frequency and intensity. Case-by-case analysis of the EMG signal showed that patients who achieved good end results had higher initial amplitude of action potentials (ARV measured before implantation) than those with poor or not persistent results (Mann–Whitney U test, p < 0.05) (Fig. 13).Fig. 11


Implantation of autologous muscle-derived stem cells in treatment of fecal incontinence: results of an experimental pilot study.

Romaniszyn M, Rozwadowska N, Malcher A, Kolanowski T, Walega P, Kurpisz M - Tech Coloproctol (2015)

Comparison of electromyography signal amplitude (IARV) in Hz before implantation in patients who did and did not achieve satisfactory results
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4631713&req=5

Fig13: Comparison of electromyography signal amplitude (IARV) in Hz before implantation in patients who did and did not achieve satisfactory results
Mentions: Twelve months after implantation, a deterioration of continence was reported by two of the six patients who achieved good results at 18 weeks. This was also reflected in the deterioration of manometric (BAP, SAP, HPZL) and EMG parameters (Figs. 5, 6, 7, 10, 11). Nevertheless, mean values were still significantly better than before the implantation. The remaining four patients (44.4 %) continued to have satisfactory results after 12 months, with reduction in frequency and intensity. Case-by-case analysis of the EMG signal showed that patients who achieved good end results had higher initial amplitude of action potentials (ARV measured before implantation) than those with poor or not persistent results (Mann–Whitney U test, p < 0.05) (Fig. 13).Fig. 11

Bottom Line: In manometric examinations 18 weeks after implantation, squeeze anal pressures and high-pressure zone length increased in all patients, with particularly significant sphincter function recovery in five patients (55.6 %).The remaining four patients (44.4 %) still described their continence as better than before implantation and retained satisfactory functional examination parameters.Implantation of autologous myoblasts gives good short-term results not only in a subjective assessment, but also in objective functional tests.

View Article: PubMed Central - PubMed

Affiliation: 3rd Department of General Surgery, Jagiellonian University Medical College, ul. Pradnicka 35-37, 31-202, Kraków, Poland. m.romaniszyn@mp.pl.

ABSTRACT

Background: The aim of this study is to present results of the implantation of autologous myoblasts into the external anal sphincter (EAS) in ten patients with fecal incontinence.

Methods: After anatomical and functional assessment of the patients' EAS, a vastus lateralis muscle open biopsy was performed. Stem cells were extracted from the biopsy specimens and cultured in vitro. Cell suspensions were then administered to the EAS. Patients were scheduled for follow-up visits in 6-week intervals. Total follow-up was 12 months.

Results: All biopsy and cell implantation procedures were performed without complications. Nine of the patients completed a full 12-month follow-up. There was subjective improvement in six patients (66.7 %). In manometric examinations 18 weeks after implantation, squeeze anal pressures and high-pressure zone length increased in all patients, with particularly significant sphincter function recovery in five patients (55.6 %). Electromyographic (EMG) examination showed an increase in signal amplitude in all patients, detecting elevated numbers of propagating action potentials. Twelve months after implantation two patients experienced deterioration of continence, which was also reflected in the deterioration of manometric and EMG parameters. The remaining four patients (44.4 %) still described their continence as better than before implantation and retained satisfactory functional examination parameters.

Conclusions: Implantation of autologous myoblasts gives good short-term results not only in a subjective assessment, but also in objective functional tests. It seems that this promising technology can improve the quality of life of patients with fecal incontinence, but further study is required to achieve better and more persistent results.

No MeSH data available.


Related in: MedlinePlus