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Preliminary Study on the Echo-Assisted Intersphincteric Autologous Microfragmented Adipose Tissue Injection to Control Fecal Incontinence in Children Operated for Anorectal Malformations

Aim of the study: To assess the efficacy of a novel technique (echo-assisted intersphincteric autologous microfragmented adipose tissue injection, also called “anal-lipofilling”) in the management of non-responsive fecal incontinence in children born with anorectal malformations (ARMs). Methods: Fol...

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Autores principales: Parente, Giovanni, Pinto, Valentina, Di Salvo, Neil, D’Antonio, Simone, Libri, Michele, Gargano, Tommaso, Catania, Vincenzo Davide, Ruggeri, Giovanni, Lima, Mario
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7656299/
https://www.ncbi.nlm.nih.gov/pubmed/33066133
http://dx.doi.org/10.3390/children7100181
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author Parente, Giovanni
Pinto, Valentina
Di Salvo, Neil
D’Antonio, Simone
Libri, Michele
Gargano, Tommaso
Catania, Vincenzo Davide
Ruggeri, Giovanni
Lima, Mario
author_facet Parente, Giovanni
Pinto, Valentina
Di Salvo, Neil
D’Antonio, Simone
Libri, Michele
Gargano, Tommaso
Catania, Vincenzo Davide
Ruggeri, Giovanni
Lima, Mario
author_sort Parente, Giovanni
collection PubMed
description Aim of the study: To assess the efficacy of a novel technique (echo-assisted intersphincteric autologous microfragmented adipose tissue injection, also called “anal-lipofilling”) in the management of non-responsive fecal incontinence in children born with anorectal malformations (ARMs). Methods: Following ethical committee approval (CHPED-MAR-18-02), anal-lipofilling was proposed to patients with fecal incontinence not responsive to medications or bowel management (bowel enema and/or transanal irrigation automatic systems), then a prospective study was conducted. Anal-lipofilling consisted of three phases: lipoaspiration from the abdominal wall, processing of the lipoaspirate with a Lipogems system and intersphincteric injection of the processed fat tissue via endosonographic assistance. A questionnaire based on Krickenbeck’s scale (KS) was administered to the patients to evaluate the clinical outcome. Main Results: Four male patients (three recto-urethral fistula, and one recto-perineal fistula) underwent the anal-lipofilling procedure at a mean age of 13.0 ± 4.2 yrs. There were no complications during or after the procedure. From an initial assessment of the patients there was an improvement in the bowel function at a median follow up of 6 months, with better scores at KS (100% Soiling grade three pre-treatment vs. 75% grade one post-treatment). Conclusions: Even if our Study is preliminary, echo-assisted anal-lipofilling could be considered as a feasible and safe alternative technique in the management of the fecal incontinence in non-responding ARMs patients. More studies are still necessary to support the validity of the implant of autologous adipose tissue in the anal sphincter as a therapy for fecal incontinence in children born with ARMs.
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spelling pubmed-76562992020-11-12 Preliminary Study on the Echo-Assisted Intersphincteric Autologous Microfragmented Adipose Tissue Injection to Control Fecal Incontinence in Children Operated for Anorectal Malformations Parente, Giovanni Pinto, Valentina Di Salvo, Neil D’Antonio, Simone Libri, Michele Gargano, Tommaso Catania, Vincenzo Davide Ruggeri, Giovanni Lima, Mario Children (Basel) Article Aim of the study: To assess the efficacy of a novel technique (echo-assisted intersphincteric autologous microfragmented adipose tissue injection, also called “anal-lipofilling”) in the management of non-responsive fecal incontinence in children born with anorectal malformations (ARMs). Methods: Following ethical committee approval (CHPED-MAR-18-02), anal-lipofilling was proposed to patients with fecal incontinence not responsive to medications or bowel management (bowel enema and/or transanal irrigation automatic systems), then a prospective study was conducted. Anal-lipofilling consisted of three phases: lipoaspiration from the abdominal wall, processing of the lipoaspirate with a Lipogems system and intersphincteric injection of the processed fat tissue via endosonographic assistance. A questionnaire based on Krickenbeck’s scale (KS) was administered to the patients to evaluate the clinical outcome. Main Results: Four male patients (three recto-urethral fistula, and one recto-perineal fistula) underwent the anal-lipofilling procedure at a mean age of 13.0 ± 4.2 yrs. There were no complications during or after the procedure. From an initial assessment of the patients there was an improvement in the bowel function at a median follow up of 6 months, with better scores at KS (100% Soiling grade three pre-treatment vs. 75% grade one post-treatment). Conclusions: Even if our Study is preliminary, echo-assisted anal-lipofilling could be considered as a feasible and safe alternative technique in the management of the fecal incontinence in non-responding ARMs patients. More studies are still necessary to support the validity of the implant of autologous adipose tissue in the anal sphincter as a therapy for fecal incontinence in children born with ARMs. MDPI 2020-10-13 /pmc/articles/PMC7656299/ /pubmed/33066133 http://dx.doi.org/10.3390/children7100181 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Parente, Giovanni
Pinto, Valentina
Di Salvo, Neil
D’Antonio, Simone
Libri, Michele
Gargano, Tommaso
Catania, Vincenzo Davide
Ruggeri, Giovanni
Lima, Mario
Preliminary Study on the Echo-Assisted Intersphincteric Autologous Microfragmented Adipose Tissue Injection to Control Fecal Incontinence in Children Operated for Anorectal Malformations
title Preliminary Study on the Echo-Assisted Intersphincteric Autologous Microfragmented Adipose Tissue Injection to Control Fecal Incontinence in Children Operated for Anorectal Malformations
title_full Preliminary Study on the Echo-Assisted Intersphincteric Autologous Microfragmented Adipose Tissue Injection to Control Fecal Incontinence in Children Operated for Anorectal Malformations
title_fullStr Preliminary Study on the Echo-Assisted Intersphincteric Autologous Microfragmented Adipose Tissue Injection to Control Fecal Incontinence in Children Operated for Anorectal Malformations
title_full_unstemmed Preliminary Study on the Echo-Assisted Intersphincteric Autologous Microfragmented Adipose Tissue Injection to Control Fecal Incontinence in Children Operated for Anorectal Malformations
title_short Preliminary Study on the Echo-Assisted Intersphincteric Autologous Microfragmented Adipose Tissue Injection to Control Fecal Incontinence in Children Operated for Anorectal Malformations
title_sort preliminary study on the echo-assisted intersphincteric autologous microfragmented adipose tissue injection to control fecal incontinence in children operated for anorectal malformations
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7656299/
https://www.ncbi.nlm.nih.gov/pubmed/33066133
http://dx.doi.org/10.3390/children7100181
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