Clinical outcome of anterior overlapping external anal sphincter repair with internal anal sphincter imbrication

被引:39
作者
Briel, JW [1 ]
de Boer, LM
Hop, WCJ
Schouten, WR
机构
[1] Univ Hosp Dijkzigt, Dept Surg, NL-3015 GD Rotterdam, Netherlands
[2] Univ Hosp Dijkzigt, Dept Epidemiol & Biostat, NL-3015 GD Rotterdam, Netherlands
关键词
fecal incontinence; obstetric trauma; anterior anal repair; direct sphincter repair;
D O I
10.1007/BF02238250
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Fecal incontinence caused by overt anterior sphincter defects sustained during childbirth is usually treated by a delayed overlapping repair of the external anal sphincter. However, an obstetric trauma is frequently associated with disruption of the perineal body and loss of the distal rectovaginal septum. Data regarding a combined repair, consisting of restoration of the rectovaginal septum and perineal body, overlapping external anal sphincter repair, and imbrication of the internal anal sphincter, are scanty. PURPOSE: This prospective study was aimed at the following. 1) evaluating the clinical outcome of such an anterior anal repair in patients with fecal incontinence caused by obstetric trauma; 2) comparing the functional results with those obtained in a historical group of patients who underwent a conventional direct sphincter repair. METHODS: During the period between 1973 and 1989, 24 female patients (median age, 44 (range, 28-67) years) with fecal incontinence underwent direct sphincter repair (Group I). During the period between 1989 and 1994, a consecutive series of 31 female patients (median age, 46 (range, 23-78) years) with fecal incontinence underwent anterior anal repair (Group II). RESULTS: At two years of follow-up, continence had been restored in 15 patients (63 percent) in Group I, whereas restoration of continence was successful in 21 patients (68 percent) in Group II. CONCLUSION: The more complex anterior anal repair fails to confer clinical benefit compared with the rather simple direct sphincter repair.
引用
收藏
页码:209 / 214
页数:6
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