Swiss surgery = Schweizer Chirurgie = Chirurgie suisse = Chirurgia svizzera · 1997
[Results of anal sphincteroplasty in fecal incontinence--significance of intra-anal ultrasound imaging].
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Peterli R, Ackermann C, Herzog U, Schuppisser J P, Tondelli P
Аннотация
UNLABELLED: The aim of the study was to evaluate the clinical, manometric and endosonographic results of overlapping sphincteroplasty for traumatic sphincter defects documented by endosonography.
PATIENTS AND METHOD: We performed an overlap repair in 10 women aged 34 to 68 with fecal incontinence due to sphincter defects after obstetric (n = 8) or iatrogenic (n = 2) trauma. The fecal incontinence was graded using the Miller Score (0-18 points). Manometry and endosonography were done pre- and postoperatively. The mean follow-up time was 17 months (6-25 m.).
RESULTS: Perioperative morbidity was low: one temporary colostomy was necessary due to an anal fistula. Eight out of 10 patients were satisfied with the result. The incontinence grade fell from an average of 14 points (8-17 points) preoperatively to 5 (0-12 points) postoperatively. The mean resting pressure increased from 36 to 41 mmHg, the voluntary contraction from 48 to 59 mmHg. Endosonography allowed the precise localization of the defect before operation and the sphincteroplasty could be visualized after operation in all the patients.
CONCLUSIONS: The overlapping sphincteroplasty improved fecal incontinence successfully in 9 of 10 patients with posttraumatic sphincter defects. Endosonography is very useful in localization of the sphincter defect and documentation of the performed sphincteroplasty.
PATIENTS AND METHOD: We performed an overlap repair in 10 women aged 34 to 68 with fecal incontinence due to sphincter defects after obstetric (n = 8) or iatrogenic (n = 2) trauma. The fecal incontinence was graded using the Miller Score (0-18 points). Manometry and endosonography were done pre- and postoperatively. The mean follow-up time was 17 months (6-25 m.).
RESULTS: Perioperative morbidity was low: one temporary colostomy was necessary due to an anal fistula. Eight out of 10 patients were satisfied with the result. The incontinence grade fell from an average of 14 points (8-17 points) preoperatively to 5 (0-12 points) postoperatively. The mean resting pressure increased from 36 to 41 mmHg, the voluntary contraction from 48 to 59 mmHg. Endosonography allowed the precise localization of the defect before operation and the sphincteroplasty could be visualized after operation in all the patients.
CONCLUSIONS: The overlapping sphincteroplasty improved fecal incontinence successfully in 9 of 10 patients with posttraumatic sphincter defects. Endosonography is very useful in localization of the sphincter defect and documentation of the performed sphincteroplasty.