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Journal of Zhejiang University SCIENCE B

ISSN 1673-1581(Print), 1862-1783(Online), Monthly

Challenges faced in the clinical application of artificial anal sphincters

Abstract: Fecal incontinence is an unresolved problem, which has a serious effect on patients, both physically and psychologically. For patients with severe symptoms, treatment with an artificial anal sphincter could be a potential option to restore continence. Currently, the Acticon Neosphincter is the only device certified by the US Food and Drug Administration. In this paper, the clinical safety and efficacy of the Acticon Neosphincter are evaluated and discussed. Furthermore, some other key studies on artificial anal sphincters are presented and summarized. In particular, this paper highlights that the crucial problem in this technology is to maintain long-term biomechanical compatibility between implants and surrounding tissues. Compatibility is affected by changes in both the morphology and mechanical properties of the tissues surrounding the implants. A new approach for enhancing the long-term biomechanical compatibility of implantable artificial sphincters is proposed based on the use of smart materials.

Key words: Fecal incontinence (FI), Artificial anal sphincter (AAS), Biomechanical compatibility, Smart materials

Chinese Summary  <30> 人工肛门括约肌临床应用所面临的挑战

概要:本文对目前临床使用的人工括约肌的安全性与有效性进行分析与讨论,对国内外目前正在开发的新装置和新方法进行比较,归纳出人工肛门括约肌在临床应用中遇到的关键问题是维持植入体与周围生物组织的远期力学相容性,该问题有望通过智能材料的利用得到解决。

关键词组:大便失禁;人工肛门括约肌;生物力学相容性;智能材料


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DOI:

10.1631/jzus.B1400242

CLC number:

R322.4+6

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On-line Access:

2015-09-05

Received:

2014-09-10

Revision Accepted:

2015-08-04

Crosschecked:

2015-08-17

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