Authors' objectives:

The aim of this systematic review was to assess the safety and efficacy of dynamic graciloplasty for the treatment of faecal incontinence.

Authors' recommendations: Safety: The safety of the procedure cannot be determined at the present time due to an incomplete and/or poor quality evidence-base. It is recommended that further research be conducted to establish safety. Specifically, since the procedure appears to have a higher morbidity rate than colostomy and owing to the technical demands of the dynamic graciloplasty, it is recommended that this operation is only performed in centres where this operation is routinely performed. It is further advised that patients must be informed as to the probability that the procedure may have to be converted to colostomy some time in the future if serious morbidity results. The actual relative risk of morbidity that dynamic graciloplasty presents in comparison to colostomy remains undetermined and should be assessed by a nonrandomised, controlled clinical trial, as randomisation may prove impossible for ethical or practical reasons. Since quality of life outcomes likewise remain undetermined, these measures should also be included in any such comparative trial. Efficacy: Efficacy is established. The procedure is equal to, or better than the best practice based on the current available evidence. The procedure may be introduced into practice. Specifically, although dynamic graciloplasty appears to be an efficacious alternative to colostomy for restoring continence in around 60% of patients (including patients who have had congenital disorders of the anorectum), it is recommended that patients be well informed of the probability of failure of this operation.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.surgeons.org/asernip-s/

Year Published: 2001

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Australia

Organisation Name: Australian Safety and Efficacy Register of New Interventional Procedures-Surgical

Contact Address: ASERNIP-S 24 King William Street, Kent Town SA 5067 Australia Tel: +61 8 8219 0900

Contact Name: racs.asernip@surgeons.org

Contact Email: racs.asernip@surgeons.org

Copyright: Australian Safety and Efficacy Register of New Interventional Procedures - Surgical (ASERNIP-S)