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