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2015 | 86 | 1 | 33-38
Tytuł artykułu

Anterior overlapping sphincteroplasty – who benefits from the surgery?

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
The aim of the study was to identify clinical factors which could influence the results of overlapping sphincteroplasty. Material and methods. Between 2003-2009 the group of 78 incontinent patients (59 women, mean age of 61±13 years), was operated on with anterior overlapping anal sphincteroplasty. Only patients with severe incontinence (>16 pts in Wexner scale) were included. Before surgery and in follow-up period anorectal ultrasound, manometry and incontinence assessment were performed and in follow-up period patients additionally fulfilled survey. The study was prospective. Follow up period was more than 36 months. Results. In survey the excellent results related to 52 patients (66.7%), good in 15 (19.2%) and poor in 11 (14.1%). The squeeze pressure improved more significantly in men 33±11 cm H2O vs. 22±14 cm H2O; p=0.039. In patients <50 year squeeze pressure was significantly larger 32±10 cm H2O vs. 25±12 cm H2O; p=0.045. If the width of a defect within sphincter was less than 60°飀 the improvement in squeeze pressure was higher 33±9 cm H2O vs. 22±15 cm H2O; p=0.031. In Wexner scale male patients better responded to surgery than females 6.94±1.8 vs. 5.12±2.2, p=0.048; as well as patients with smaller scar <60° 6.51±1.4 vs. 4.28±2.3; p=0.042. Conclusions. To succeed in sphincteroplasty the proper qualification to the procedure should be crucial. Clinical assessment prior to surgery with the use of all available non-surgical methods in patients suffer from severe symptoms can help to select optimal group who will benefit from surgery. Male patients may have to obtain better outcome and patients with smaller sphincter defect could likely have also better results from surgery.
Wydawca

Rocznik
Tom
86
Numer
1
Strony
33-38
Opis fizyczny
Daty
wydano
2014-01-01
online
2014-02-27
Twórcy
autor
  • Department of General and Colorectal Surgery, Medical University in Łódź, m.mik@wp.pl
  • Department of General and Colorectal Surgery, Medical University in Łódź
  • Department of General and Colorectal Surgery, Medical University in Łódź
  • Department of General and Colorectal Surgery, Medical University in Łódź
  • Department of General and Colorectal Surgery, Medical University in Łódź
  • Department of General and Colorectal Surgery, Medical University in Łódź
autor
  • Department of General and Colorectal Surgery, Medical University in Łódź
Bibliografia
  • 1. Nelson RL: Epidemiology of fecal incontinence. Gastroenterology 2004; 126 (1 Suppl. 1): S3-S7.
  • 2. Madoff RD, Parker SC , Varma MG et al.: Faecal incontinence in adults. Lancet 2004; 364: 621-32.[Crossref][PubMed]
  • 3. Bharucha AE : Fecal incontinence. Gastroenterology 2003; 124: 1672-85.[PubMed][Crossref]
  • 4. Lockhart-Mummery JP: Diseases of the rectum & colon and their surgical treatment. Toronto: MacMillan 1923: 685-86.
  • 5. Parks AG, McPartlin JF: Late repair of injuries of the anal sphincter. Proc R Soc Med 1971; 64: 1187-89.
  • 6. A ltomare DF, De Fazio M, Giuliani RT et al.: Sphincteroplasty for fecal incontinence in the era of sacral nerve modulation. World J Gastroenterol 2010; 16: 5267-71.[PubMed][WoS]
  • 7. Brown SR , Wadhawan H, Nelson RL: Surgery for faecal incontinence in adults. Cochrane Database Syst Rev 2010; 8: CD001757.
  • 8. Gearhart S, Hull T, Floruta C et al.: Anal manometric parameters: predictors of outcome following anal sphincter repair? J Gastrointest Surg 2005; 9: 115-20.[Crossref][PubMed]
  • 9. H a HT, Fleshman JW , Smith M et al.: Manometric squeeze pressure difference parallels functional outcome after overlapping sphincter reconstruction.Dis Colon Rectum 2001; 44: 655-60.[PubMed]
  • 10. Baig MK, Wexner SD: Factors predictive of outcome after surgery for faecal incontinence. BJS 2000; 87: 1316-30.[Crossref]
  • 11. O liveira L, Pfeifer J, Wexner SD: Physiological and clinical outcome of anterior sphincteroplasy.BJS 1996; 83: 502-05.
  • 12. K ettle C, Johanson RB: Absorbable synthetic versus catgut suture material for perineal repair.Cochrane Database Syst Rev 2000; 2: CD000006.Update in: Cochrane Database Syst Rev 2010; 6: CD000006.
  • 13. Parnell BA, Whitehead WE , Geller EJ et al.: Overlapping anal sphincteroplasty: impact of suture selection on bowel symptoms. J Reprod Med 2011; 56: 187-91.[PubMed]
  • 14. Bravo-Gutierrez A, Madoff RD, Lowry AC et al.: Long-term results of anterior sphincteroplasty. Dis Colon Rectum 2004; 47: 727-31.
  • 15. Halverson AL, Hull TL: Long-term outcome of overlapping anal sphincter repair. Dis Colon Rectum 2002; 45: 345-48.[PubMed][Crossref]
  • 16. Barisic G, Krivokapic Z, Markovic V et al.: The role of overlapping sphincteroplasty in traumatic fecal incontinence. Acta Chir Iugosl 2000; 47: 37-41.[PubMed]
  • 17. K aroui S, Leroi AM, Koning E et al.: Results of sphincteroplasty in 86 patients with anal incontinence.Dis Colon Rectum 2000; 43: 813-20.
  • 18. Malouf AJ , Norton CS , Engel AF et al.: Longterm results of overlapping anterior anal-sphincter repair for obstetric trauma. Lancet 2000; 355: 260-65.[Crossref]
  • 19. Young CJ , Mathur MN, Eyers AA et al.: Successful overlapping anal sphincter repair: relationship to patient age, neuropathy, and colostomy formation. Dis Colon Rectum 1998; 41: 344-49.[Crossref][PubMed]
  • 20. Goetz LH, Lowry AC : Overlapping sphincteroplasty: is it the standard of care? Clin Colon Rectal Surg 2005; 18: 22-31.[PubMed][Crossref]
  • 21. R asmussen OO , Puggaard L, Christiansen J: Anal sphincter repair in patients with obstetric trauma: age affects outcome. Dis Colon Rectum 1999; 42: 193-95.
  • 22. Nikiteas N, Korsgen S, Kumar D et al.: Audit of sphincter repair. Factors associated with poor outcome. Dis Colon Rectum 1996; 39: 1164-70.[Crossref][PubMed]
  • 23. Tjandra JJ , Chan MK, Kwok SY et al.: Predictive factors for faecal incontinence after third or fourth degree obstetric tears: a clinico-physiologic study. Colorectal Dis 2008; 10: 681-88.[WoS][PubMed][Crossref]
  • 24. Chen AS , Luchtefeld MA, Senagore AJ et al.: Pudendal nerve latency. Does it predict outcome of anal sphincter repair? Dis Colon Rectum 1998; 41: 1005-09.[PubMed][Crossref]
  • 25. Gilliland R, Altomare DF, Moreira H Jr et al.: Pudendal neuropathy is predictive of failure following anterior overlapping sphincteroplasty. Dis Colon Rectum 1998; 41: 1516-22.[Crossref][PubMed]
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_pjs-2014-0006
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