Injection of aluminum potassium sulfate and tannic acid in the treatment of fecal incontinence: a single-center observational study

Abe Tatsuya; Kunimoto Masao; Hachiro Yoshikazu; Ohara Kei; Inagaki Mitsuhiro

doi:10.3393/ac.2021.00248.0035

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자료유형: 학술저널

저자정보: Abe Tatsuya (Department of Proctology Kunimoto Hospital Asahikawa Hokkaido Japan) Kunimoto Masao (Department of Proctology Kunimoto Hospital Asahikawa Hokkaido Japan) Hachiro Yoshikazu (Department of Proctology Kunimoto Hospital Asahikawa Hokkaido Japan) Ohara Kei (Department of Proctology Kunimoto Hospital Asahikawa Hokkaido Japan) Inagaki Mitsuhiro (Department of Proctology Kunimoto Hospital Asahikawa Hokkaido Japan)

저널정보: 대한대장항문학회 Annals of Coloproctology Annals of Coloproctolgy Vol.38 No.6

발행연도: 2022.12

수록면: 403 - 408 (6page)

DOI: 10.3393/ac.2021.00248.0035

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Purpose: Perianal injection of bulking agents is an attractive treatment option for patients with mild to moderate fecal incontinence (FI). Various bulking agents have been used for injection therapy, but the optimal injection materials and methods are yet to be standardized. This study aimed to evaluate the effects of injection therapy using aluminum potassium sulfate and tannic acid (ALTA) in the management of FI. Methods: This study included consecutive patients who underwent ALTA injection therapy for FI at our institution. The procedure was performed with the patient in the jackknife position, under caudal epidural anesthesia. The procedure consisted of a 4-step injection to the 3 main cushions and a multipoint injection to the remaining submucosa of the anal canal. Results: Seventy-seven patients (mean age, 76 years) were enrolled in the study. The mean Cleveland Clinic incontinence score of 11.9 ± 4.1 at baseline significantly improved to 7.3 ± 5.2 at 3 months following treatment. The mean maximal resting pressure also increased significantly 3 months after the intervention. Postoperative complications were observed in 3 patients (3.9%), and all events were mild. The mean duration of postoperative follow-up was 17.5 months. The cumulative recurrence-free rate at 3 years was 72.4%. Conclusion: ALTA injection for FI is safe, easy to perform, and provides reasonable mid-term outcomes. Moreover, concomitant anorectal diseases that may be contraindicated by other injectable bulking agents could be treated simultaneously. Therefore, ALTA injection is a promising alternative in the absence of other injectable agents.

#Fecal incontinence #Anal canal #Sclerotherapy #Aluminum potassium sulfate and tannic acid

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