Physiological and histochemical adaptation of the electrically stimulated gracilis muscle to neoanal sphincter function
Article first published online: 6 DEC 2005
Copyright © 1993 British Journal of Surgery Society Ltd.
British Journal of Surgery
Volume 80, Issue 10, pages 1342–1346, October 1993
How to Cite
George, B. D., Williams, N. S., Patel, J., Swash, M. and Watkinst, E. S. (1993), Physiological and histochemical adaptation of the electrically stimulated gracilis muscle to neoanal sphincter function. Br J Surg, 80: 1342–1346. doi: 10.1002/bjs.1800801042
- Issue published online: 6 DEC 2005
- Article first published online: 6 DEC 2005
- Manuscript Accepted: 29 JAN 1993
The physiological and histochemical characteristics of the gracilis muscle were studied in 19 patients undergoing electrically stimulated gracilis neosphincter construction. Indications for surgery were faecal incontinence (n = 11) and reconstruction following sphincter excision or congenital absence (n = 8). Transposition of the gracilis muscle around the anal canal followed by chronic low-frequency electrical stimulation was associated with a shift in the frequency-response curve and a prolongation of the time-course of individual muscle twitches suggestive of transformation to a slow-twitch fatigue-resistant type. Temporary cessation of electrical stimulation resulted in a reversal of the frequency-response changes. Muscle biopsies taken before and a median of 80 (range 49–137) days after transposition and low-frequency electrical stimulation indicated a significant increase in the proportion of type 1 fibres and a significant decrease in their diameter. These results show that the human gracilis muscle is capable of physiological and histochemical adaptation to long-term neosphincter function.