PURPOSE: Transformation of fast-twitching skeletal muscles to slow-twitching, slowly fatigable muscles has become of clinical interest in the recent past. Transposition and transformation of the gracilis muscle to use it as a substitute for a resected or defected anal sphincter (graciloplasty) have been reported as achieving promising results in the treatment of @entity1241 caused by sphincter defects or following abdominoperineal anorectal excision for @entity5 . METHOD: This experimental study used a @entity235 model and the sartorius muscle to evaluate the functional efficiency of two different configurations of the muscle loop to compare the presently applied transformation program (8 weeks) with a shorter (5 weeks) protocol. In six @entity235 , both sartorius muscles were wrapped around two stomas, either in an alpha fashion or in the so-called split-sling technique. Muscle transformation was achieved by controlled neuromuscular stimulation either during eight (Program A) or five weeks (Program B). After completion of the transformation period, the function of the @entity121 was evaluated by manometry, and histomorphologic evaluation of the sartorius muscles was performed. RESULTS: It was shown that muscle transformation led to a slowly fatigable muscle that made it possible to perform continuos (tetanic) contraction, regardless of the configuration or the duration of the transformation. Median pressures created by these muscles also did not differ significantly. In accordance with these functional findings, the histologic evaluation showed the typical, significant increase of Type I fibers in both @entity121 and following both transformation protocols. Although the decrease of fast-twitching @entity1605 was more pronounced following the conventional (8 weeks) program, this finding did not influence the functional results. CONCLUSIONS: Results of our experiment indicate the possibility for using a shorter transformation protocol for transformation of the gracilis muscle during graciloplasty in the clinical setting. Furthermore, the efficacy and safety of the modified (split-sling) wrap technique was demonstrated.

Muscle transformation of the sartorius muscle in a XXXX model: clinical impact for electrodynamic graciloplasty as a "neosphincter".

@entity1605 :: ('OMIM:217000', 'Disease') :: ['Type II fibers'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity235 :: ('9615', 'Species') :: ['canine', 'beagle dogs'] @entity1241 :: ('MESH:D005242', 'Disease') :: ['fecal incontinence'] @entity121 :: ('MESH:D009135', 'Disease') :: ['muscle slings']
@entity235 :: (9615,Species) :: ['canine']
