RESUMO
OBJECTIVE: To assess the long term clinical results of anterior sphincter plication for traumatic rupture of the anal sphincters. DESIGN: Retrospective study. SETTING: University hospital, The Netherlands. SUBJECTS: 28 consecutive patients with traumatic faecal incontinence after injury to the anal sphincters. MAIN OUTCOME MEASURES: Clinical outcome and its correlation with anorectal manometry. RESULTS: After a mean (SD) follow up of 50 (37) months 21 patients were classified grades 1 and 2 (satisfied) and seven patients were grades 3 and 4 (classified). There were significant differences after operation between the 21 patients in grades 1 and 2 compared with the 7 in grades 3 and 4 in median resting pressure (43 compared with 25 mmHg, p = 0.004, 95% CI 9 to 40), and squeeze pressure (100 compared with 40 mmHg, p = 0.001, 95% CI 15 to 80) but not in length of high pressure zone (3.5 compared with 2.3 cm, p = 0.14, 95% CI -0.2 to +2.2). (Mann Whitney U test was used.) CONCLUSION: Long term follow up of patients after anterior sphincter plication showed good results in three quarters of patients, and 57% were fully continent. Good postoperative results correlate with significant increases in resting and squeeze pressures.
Assuntos
Canal Anal/lesões , Canal Anal/cirurgia , Incontinência Fecal/etiologia , Incontinência Fecal/cirurgia , Músculos Abdominais/cirurgia , Adulto , Idoso , Canal Anal/fisiopatologia , Colostomia/efeitos adversos , Incontinência Fecal/fisiopatologia , Feminino , Seguimentos , Hematoma/etiologia , Humanos , Masculino , Manometria , Pessoa de Meia-Idade , Satisfação do Paciente , Pressão , Reto/fisiopatologia , Estudos Retrospectivos , Ruptura , Deiscência da Ferida Operatória/etiologia , Resultado do TratamentoRESUMO
OBJECTIVE: To assess the long term clinical results of postanal repair for idiopathic faecal incontinence. DESIGN: Retrospective study. SETTING: University hospital, The Netherlands. SUBJECTS: 38 patients with idiopathic faecal incontinence. MAIN OUTCOME MEASURES: Clinical outcome and its correlation with anorectal manometry. RESULTS: After a median follow up of 43 months (15-126) 19 patients were classified grades 1 and 2 (satisfied) and 19 patients grades 3 and 4 (dissatisfied). Six patients deteriorated and went from grades 1 or 2 to grade 3 or 4. Satisfied patients had a significant rise in resting pressure (median 13.5 mmHg, p = 0.01, 95% CI 5 to 25) and dissatisfied patients did not. CONCLUSION: Long term follow up of patients after postanal repair shows that half the patients have a good result, although only 21% are fully continent. Long term follow up is necessary as a number of patients deteriorate.
