Acta Scientific Gastrointestinal Disorders (ASGIS)(ISSN: 2582-1091)

Research Article Volume 4 Issue 7

Anal Sphincter Repair for Fecal Incontinence. Experience from a Secondary Care Center

Torres Carlos1*, Gil Dina2, Torres Douglas3 and Salinas Pedro4

1Colorectal Unit, División of Surgery, Hospital Sor Juana Inés de la Cruz, Mérida, Venezuela
2Colorectal Unit, División of Surgery, IAHULA, Mérida, Venezuela
3Professor (Investigation y Postgraduate, UNEFA), Caracas, Venezuela
4Faculty of Medicine, Mérida, Venezuela

*Corresponding Author:Torres Carlos, Colorectal Unit, División of Surgery, Hospital Sor Juana Inés de la Cruz, Mérida, Venezuela.

Received: June 01, 2021; Published: June 11, 2021

Abstract

Background: Fecal incontinence (FI) is a chronic and debilitating condition that carries a significant health, economic, and social burden. This disease is characterized by the frequency of episodes and the consistency of the feces. The aim of this study was to review our experience with overlapping sphincteroplasty to assess its efficacy on the surgical treatment of fecal incontinence.

Methods: Retrospective study was conducted for all patients who underwent overlapping sphincteroplasty in our institution from April 2007 to May 2017, for Fecal Incontinence with defects sphincter, at the Hospital Sor Juana Ines de la Cruz. All patients had evidence of a sphincter defect during physical examination, which was confirmed by Endoanal Ultrasound. Follow-up data were gathered from outpatient clinic visits and were obtained last office visit. The patients with fecal incontinence were asked Cleveland Clinic Florida Fecal Incontinence score (CCFFISW) Wexner score was registered preoperatively and 6 weeks postoperatively were collected.

Results: We performed twenty one overlapping sphincteroplasty for patients with fecal incontinence during a study period of ten years. Patients mean age was 56.95 years ± 14.95, range (25 - 78). The etiologies were 11 patient’s Obstetric injury (52.38%), Diabetes Mellitus six patients (28.57%), anorectal surgery 3 patients (14.28%) and one patient who had traumatic rectal impalement (4.76%). The mean of CCFFIS Score Wexner decreased from 19.19 (range 17 - 20) to 9 (range 5 -18) after sphincteroplasty, with improved quality of lifestyle 12 months after procedure, even young patients affirmed to have sexual function improved. The median follow-up time was 12 (range 6 - 24, ± 14.38) months. Postoperative wound dehiscence partial was the most common complications after sphincteroplasty in 15 patients (71.42%). Only one patient went another hospital and undergone to terminal colostomy. One patient failed sphincteroplasty, and after one year had undergone a repeat.

Conclusion: The overlapping sphincteroplasty is an effective treatment of choice for fecal incontinent patients with defects sphincter. This procedure still has a positive role to play in the management of fecal incontinence and has low costs when are compare with another surgical procedure for fecal incontinence.

Keywords: Fecal Incontinence; Sphincteroplasty; Sphincter Defect; Sphincter Repair

References

  1. Katarzyna B and Boller Anne Marie. “Fecal Incontinence: Epidemiology, Impact, and Treatment”. Clinics in Colon and Rectal Surgery 29 (2016): 264-270.
  2. Whitehead WE., et al. “Fecal incontinence in US adults: epidemiology and risk factors”. Gastroenterology 137 (2009): 512-517.
  3. Lazarescu A., et al. “Investigating and treating fecal incontinence: when and how”. Canadian Journal of Gastroenterology4 (2009): 301-308.
  4. Ng KS., et al. “Fecal incontinence: community prevalence and associated factors—a systematic review”. Diseases of the Colon and Rectum12 (2015): 1194-1209.
  5. Rao SS. “Diagnosis and management of fecal incontinence. American College of Gastroenterology Practice Parameters Committee”. The American Journal of Gastroenterology 99 (2004): 1585-1604.
  6. Ditah I., et al. “Prevalence, trends, and risk factors for fecal incontinence in United States adults, 2005-2010”. Clinical Gastroenterology and Hepatology 12 (2014): 636-643.
  7. Bharucha AE., et al. “Epidemiology, pathophysiology, and classification of fecal incontinence: state of the science summary for the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) workshop”. The American Journal of Gastroenterology 110 (2015): 127-136.
  8. Sun WM., et al. “Utility of a combined test of anorectal manometry, electromyography, and sensation in determining the mechanism of ‘idiopathic’ faecal incontinence”. Gut 33 (1992): 807-813.
  9. Jorge JM and Wexner SD. “Etiology and management of fecal incontinence”. Diseases of the Colon and Rectum 36 (1993): 77-97.
  10. Vaizey CJ., et al. “Prospective comparison of faecal incontinence grading systems”. Gut 44 (1999): 77-80.
  11. Rockwood TH., et al. “Fecal Incontinence Quality of Life Scale: quality of life instrument for patients with fecal incontinence”. Diseases of the Colon and Rectum 43 (2000): 9-16.
  12. Lockhart-Mummery JP. “Diseases of the rectum and colon and their surgical treatment”. Toronto: MacMillan (1923): 685-686.
  13. Parks AG and McPartlin JF. “Late repair of injuries of the anal sphincter”. Journal of the Royal Society of Medicine 64 (1971): 1187-1189.
  14. Goetz LH and Lowry AC. “Overlapping sphincteroplasty: is it the standard care”. Clinics in Colon and Rectal Surgery 18 (2005): 22-31.
  15. Londono-Schimmer EE., et al. “Overlapping anal sphincter repair for faecal incontinence due to sphincter trauma: five year follow-up functional results”. The International Journal of Colorectal Disease 9.2 (1994): 110-113.
  16. Fang DT., et al. “Overlapping sphincteroplasty for acquired anal incontinence”. Diseases of the Colon and Rectum 11 (1984): 720-722.
  17. Sangalli MR and MartiMC. “Results of sphincter repair in postobstetric fecal incontinence”. Journal of the American College of Surgeons5 (1994): 583-586.
  18. Malouf AJ., et al. “Long-term results of overlapping anterior anal-sphincter repair for obstetric trauma”. Lancet 9200 (2000): 260-265.
  19. Chase S., et al. “Anal sphincter repair for fecal incontinenece:´experience from a tertiary care centre”. Indian Journal of Gastroenterology 29 (2010): 162-165.
  20. Eccersley AJ and Williams NS. “Fecal incontinence-pathophysiology and management”. In: Pemberton JH, Swash M, Henry M, eds. The Pelvic Floor. Its Function and Disorders. Philadelphia, PA: WB Saunders; (2002): 341-357.
  21. Klosterhalfen B., et al. “Sclerosis of the internal anal sphincter-a process of aging”. Diseases of the Colon and Rectum 33 (1990): 606-609.
  22. Rogers J., et al. “Pelvic floor neuropathy: a comparative study of diabetes mellitus and idiopathic faecal incontinence”. Gut 29 (1988): 756-761.
  23. Sitzler PJ and Thomson JP. “Overlap repair of damaged anal sphincter. A single surgeon’s series”. Diseases of the Colon and Rectum 39 (1996): 1356-1360.
  24. Zorcolo L., et al. “Outcome of anterior sphincter repair for obstetric injury: comparison of early and late results”. Diseases of the Colon and Rectum3 (2005): 524-531.
  25. Karoui S., et al. “Results of sphincteroplasty in 86 patients with anal incontinence”. Diseases of the Colon and Rectum6 (2000): 813-820.

Citation

Citation: Torres Carlos., et al. “Anal Sphincter Repair for Fecal Incontinence. Experience from a Secondary Care Center”. Acta Scientific Gastrointestinal Disorders 4.7 (2021): 27-31.

Copyright

Copyright: © 2021 Torres Carlos., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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Acceptance rate35%
Acceptance to publication20-30 days
Impact Factor0.835

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