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Article

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

1
Pediatric Surgery Department, Sant’Orsola-Malpighi University Hospital, 40138 Bologna, Italy
2
Plastic Surgery, Sant’Orsola-Malpighi University Hospital, 40138 Bologna, Italy
*
Author to whom correspondence should be addressed.
Received: 8 September 2020 / Revised: 6 October 2020 / Accepted: 8 October 2020 / Published: 13 October 2020
(This article belongs to the Special Issue Pediatric Gastroenterology and Nutrition)
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. View Full-Text
Keywords: anorectal malformation; fecal incontinence; bowel management; endoanal ultrasound; anal-lipofilling anorectal malformation; fecal incontinence; bowel management; endoanal ultrasound; anal-lipofilling
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MDPI and ACS Style

Parente, G.; Pinto, V.; Di Salvo, N.; D’Antonio, S.; Libri, M.; Gargano, T.; Catania, V.D.; Ruggeri, G.; Lima, M. Preliminary Study on the Echo-Assisted Intersphincteric Autologous Microfragmented Adipose Tissue Injection to Control Fecal Incontinence in Children Operated for Anorectal Malformations. Children 2020, 7, 181. https://0-doi-org.brum.beds.ac.uk/10.3390/children7100181

AMA Style

Parente G, Pinto V, Di Salvo N, D’Antonio S, Libri M, Gargano T, Catania VD, Ruggeri G, Lima M. Preliminary Study on the Echo-Assisted Intersphincteric Autologous Microfragmented Adipose Tissue Injection to Control Fecal Incontinence in Children Operated for Anorectal Malformations. Children. 2020; 7(10):181. https://0-doi-org.brum.beds.ac.uk/10.3390/children7100181

Chicago/Turabian Style

Parente, Giovanni, Valentina Pinto, Neil Di Salvo, Simone D’Antonio, Michele Libri, Tommaso Gargano, Vincenzo D. Catania, Giovanni Ruggeri, and Mario Lima. 2020. "Preliminary Study on the Echo-Assisted Intersphincteric Autologous Microfragmented Adipose Tissue Injection to Control Fecal Incontinence in Children Operated for Anorectal Malformations" Children 7, no. 10: 181. https://0-doi-org.brum.beds.ac.uk/10.3390/children7100181

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