Further validation of the Wexner Incontinence Score: A note of appreciation and gratitude

Surgery ◽  
2021 ◽  
Keyword(s):  
Incontinence Score

Therapeutic Effect of Changqiang Acupoint Injection on Children with Functional Fecal Incontinence

2021 ◽  
Author(s):  
Changying Yi ◽  
Jie Zhang ◽  
Meili Fan
Keyword(s):  
Treatment Group ◽  
Fecal Incontinence ◽  
Cleveland Clinic ◽  
Control Group ◽  
Incontinence Score ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled ◽  
Stool Incontinence ◽  
Acupoint Injection ◽  
Significant Difference

<B>Objective:</B> Functional fecal incontinence in children (FFIC), also known as functional fecal disorder in children, is a type of childhood diseases characterized by excretory dysfunction. In the study, we observed the clinical effect of Changqiang acupoint injection on functional fecal incontinence in children (FFIC) by randomized controlled clinical trials. <BR><B>Materials and methods:</B> 140 children with functional fecal incontinence who met the screening criteria were respectively assigned into the treatment group (100 cases) and the control group (40 cases) according to the completely randomized controlled design. In the treatment group, Chuankezhi injection was administrated at the Changqiang acupoint once a week for three weeks (one course of treatment). In contrast, the subjects in the control group was instructed to receive sphincter exercise and defecation training, followed by an assessment on the therapeutic efficacy after one course of treatment. <BR><B>Results:</B> The overall response rate of the two groups was 93.00% (93/100) and 57.50% (23/40), respectively, with a statistically significant difference (P<0.01). The treatment group showed a performance superior to the control group based on the Cleveland Clinic Florida Fecal Incontinence Score System (CCF-FI)—dry stool incontinence, liquid incontinence, gas incontinence, lifestyle change, necessity of using pads or antidiarrheals, the ability to delay defecation, and the total score. The inter-group comparison revealed a statistically significant difference (P<0.01). <BR><B>Conclusion:</B>Changqiang acupoint injection has significant curative effect on FFIC as demonstrated by significant relief in the symptoms associated with fecal incontinence, and thus is considered as a useful approach to be widely applied in clinical practice.

The bother of anal incontinence and St. Mark’s Incontinence Score

2015 ◽  
Vol 20 (2) ◽  
pp. 123-128 ◽  
Author(s):  
C. Paka ◽  
I. K. Atan ◽  
H. P. Dietz
Keyword(s):  
Anal Incontinence ◽  
Incontinence Score

Transcutaneous tibial nerve stimulation for the treatment of faecal incontinence: results of a prospective study

2014 ◽  
Vol 21 (2) ◽  
pp. 91-98 ◽  
Author(s):  
Ieva Stundienė ◽  
Paulius Žeromskas ◽  
Jonas Valantinas
Keyword(s):  
Quality Of Life ◽  
Prospective Study ◽  
Faecal Incontinence ◽  
Nerve Stimulation ◽  
Tibial Nerve ◽  
Cleveland Clinic ◽  
Life Questionnaire ◽  
Incontinence Score ◽  
Tibial Nerve Stimulation

Background. Transcutaneous tibial nerve stimulation is a simple, non-invasive treatment, which can be used to treat faecal incontinence. Optimal treatment regimen is not known and various stimulation regimens are used in different centers. The aim of this prospective study was to evaluate the efficacy of twice weekly transcutaneous tibial nerve stimulation for faecal incontinence patients, who have failed to respond to maximal conservative treatment. Material and methods. Twenty patients with faecal incontinence resistant to maximal conservative therapy were treated with transcutaneous posterior tibial nerve stimulation twice a week for six weeks. The number of the bowel movements per two weeks and the Cleveland Clinic Florida Feacal Incontinence Score were assessed before and after the treatment. The quality of life was estimated using the Faecal Incontinence Quality of Life questionnaire and the Gastrointestinal Quality of Life Index. Results. Effect was seen in 55% of patients. Two-week faecal incontinence episodes decreased from median 4  (2–84) to 2  (0–56) (p = 0.002). The mean Cleveland Clinic Florida Faecal Incontinence score improved from 10.9 ± 4.34 to 7.8 ± 3.96 (p = 0.002). The quality of life improved significantly after the treatment. The therapy was well tolerated and no participant experienced any adverse event. Conclusions. Transcutaneous tibial nerve stimulation twice a week for 6 weeks may be efficacious in patients with faecal incontinence, who have failed to respond to maximal conservative treatments.

Effects of adjuvant oxaliplatin on anal function in locally advanced rectal cancer treated with preoperative chemoradiotherapy and low anterior resection.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 718-718
Author(s):  
Fernando Arias ◽  
Clara Eito ◽  
Antonio Viudez ◽  
Gemma Asin ◽  
Berta Ibañez ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Adjuvant Treatment ◽  
Anterior Resection ◽  
Locally Advanced ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Anal Function ◽  
Sphincter Function ◽  
Anal Sphincter Function ◽  
Incontinence Score

718 Background: The main purpose of the present study was to determine if the addition of adjuvant oxaliplatin (OXA) could have some influence on sphincter function in patients with locally advanced rectal cancer (LARC) treated with preoperative capecitabine/radiotherapy followed by lower anterior resection (LAR). Methods: Those patients with LARC treated at our center with LAR and without two-years loco-regional relapse were retrospectively analyzed independent of the type of adjuvant treatment received. Anal sphincter function was assessed by Wexner´s incontinence score (0 to 20 points, being punctuation inversely proportional to sphincter function). All questionnaires were completed between January 2010 and December 2012. Comparisons of sphincter function measured with the Wexner test between patients with and without OX were conducted with the Mann-Whitney test. Statistical analyses were conducted using IBM SPSS Statistics, version 20. Results: From 2006, 92 consecutive patients were included in our study. Mean time from LAR to fecal function assessment was 58 months (25 to 96 months). Wexner test median values did not differ significantly (p=0.450) between patients with and without adjuvant OXA. The median (IQR) for the group without adjuvant OXA was 6.0 (1.0-11.25), being for group that received adjuvant OXA of 5.0 (1.0-10.0). Conclusions: Based on our findings, OXA could be used as adjuvant treatment in LARC, due to its absent of deleterious influence over the sphincter anal function. Because of the retrospective nature of our study, prospective studies should be warranted in similar scenarios. This study has been supported by a grant of “Mutua Madrileña Fundation.”

scholarly journals Coloplasty Neorectum versus Straight Anastomosis in Low Rectal Cancers

ISRN Surgery ◽  
2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Fazl Q. Parray ◽  
Javaid A. Magray ◽  
Manzoor Ahmad Dar ◽  
Nisar A. Chowdri ◽  
Rauf A. Wani ◽  
...  
Keyword(s):  
Total Mesorectal Excision ◽  
Anal Verge ◽  
Anastomosis Group ◽  
Bladder Function ◽  
Random Allocation ◽  
Mesorectal Excision ◽  
Incontinence Score ◽  
Significant Difference ◽  
Carcinoma Rectum ◽  
Transverse Coloplasty

Introduction. Patients with the diagnosis of carcinoma rectum after random allocation were assigned to 2 groups. One group was subjected to total mesorectal excision with coloplasty neorectum reconstruction and another group to total mesorectal excision with straight anastomosis. This randomization was done by odds and even method by the sister in charge of the ward to avoid bias in randomization. The study included 42 patients with diagnosis of carcinoma rectum from 4 to 12 centimeters from anal verge. Composite incontinence score, bladder function, and sexual function were considered as the main outcome measures. Results. All patients of transverse coloplasty group had mild or moderate composite incontinence score while 7 (36.8%) patients of straight anastomosis group had a severe score at 7th POD (P<0.05). At 6 months, 100% patients in transverse coloplasty group had a nil score which was not achieved by any of the patients in the other group. An intragroup comparison showed an improvement in score with time in both groups more marked in transverse coloplasty group. Conclusion. Transverse coloplasty group showed a better QOL so far as anal incontinence is considered. However, no statistically significant difference was achieved when comparing bladder and sexual dysfunction between the two groups.

scholarly journals A prospective interventional study of postoperative pain, healing rates and incontinence rates following ligation of intersphincter fistula tract procedure

2018 ◽  
Vol 5 (12) ◽  
pp. 3976
Author(s):  
Arunraj P. ◽  
Viswanathan M. S. ◽  
Anbazhagan R. ◽  
Kulwant Singh
Keyword(s):  
Wound Healing ◽  
Postoperative Pain ◽  
Anal Fistula ◽  
Fistula Tract ◽  
Fistula In Ano ◽  
Sphincter Function ◽  
Incontinence Score ◽  
Group A ◽  
Complete Wound Healing ◽  
Group B

Background: Fistula in ano is one of the oldest ailments known to us, troublesome both to the patient and also challenging to the treating surgeon. The treatment of fistula in ano has evolved so much, to reduce complications and to improve patient’s compliance. This study was conducted to compare the age old method of open fistulectomy to that of recently developed technique of ligation of intersphincter fistula tract (LIFT), in patients suffering from low fistula in ano.Methods: A totally of 80 patients, suffering from low anal fistula was divided randomly into two groups. Group A: undergoing LIFT procedure and Group B: undergoing open fistulectomy procedure .The two groups were compared in the postoperative period for wound healing, postoperative pain (by visual analog scale) and fecal incontinence (by Wexner incontinence score).Results: Group A patients who underwent LIFT at the end of 3rd postoperative week had a pain score of 0.43 when compared to group B patients (1.33) who underwent fistulectomy. Group A patients had 100% continence preservation, whereas a 17.5% of moderate incontinence was documented in Group B patients. About 97.5% of patients under Group A had complete wound healing by the 3rd postoperative week, as compared to group B patients, where100% complete wound healing was noted at 6 weeks, postoperatively.Conclusions: It was found that LIFT was a promising procedure in reducing the postoperative pain significantly, with better wound healing rates. It was effective in maintaining good sphincter function, thereby providing better faecal continence following surgery, in low anal fistula.

scholarly journals 1057 Outcome Reporting Following Rectopexy Requires Standardisation for Reproducibility and Transparent Outcome Analysis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
H Wa Katolo ◽  
C Fleming ◽  
G Wilkinson ◽  
A Brannigan
Keyword(s):  
Quality Of Life ◽  
Rectal Prolapse ◽  
English Language ◽  
Cleveland Clinic ◽  
Outcome Analysis ◽  
Incontinence Score ◽  
Outcome Reporting ◽  
Randomised Controlled ◽  
The Impact

Abstract Aim Rectopexy is a surgical procedure commonly used to correct rectal prolapse. Several studies have investigated different approaches (abdominal, perineal) and techniques (open, laparoscopic, robotic) in this field however reporting outcomes vary significantly among studies impeding comparison of techniques. We aimed to comprehensively analyse primary outcome reporting methods following rectopexy in published literature. Method A systematic search was performed in keeping with PRISMA guidelines and search protocol registered with PROSPERO. Published databases were searched using the following terms: “rectopexy”, “abdominal rectopexy” and “rectopexy outcomes”. Randomised controlled trials, comparative and non-comparative prospective and retrospective studies published between 1992 and 2019 were included for analysis. Review articles, letters, editorials, abstracts, and non-English language studies were excluded. A narrative description of outcomes was reported. Results A total of 1089 articles were screened, and 32 articles were identified as suitable for inclusion, reporting on 1780 patients who underwent rectopexy surgery. Over 30 unique methods of reporting outcomes were recorded, with the most common being the rate of recurrence (n = 15), Cleveland Clinic Faecal Incontinence score (CCIS) (n = 11), and customised symptom questionnaires (n = 10). Many studies recognised the impact of symptoms of rectal prolapse on patients’ quality of life (QoL) however, few utilised standardised quality of life scores to evaluate the outcome of the procedures. Conclusions As surgical technique evolves in rectopexy, incorporating minimally invasive surgery and robotic surgery, it is important that outcome reporting is standardised to facilitate transparent comparison. Improving patient QoL is the mainstay of surgical intervention and it is important that QoL outcome measures are incorporated.

scholarly journals Long-Term Functional Results of a Modified Caudal-to-Cranial Approach in Laparoscopic Segmental Left Colectomy for Diverticular Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Michele Manigrasso ◽  
Marcella Pesce ◽  
Marco Milone ◽  
Pietro Anoldo ◽  
Anna D’Amore ◽  
...  
Keyword(s):  
Surgical Approach ◽  
Short Form ◽  
Standard Procedure ◽  
Reference Value ◽  
Left Colectomy ◽  
Incontinence Score ◽  
Asa Score ◽  
Low Tie ◽  
Uncomplicated Diverticulitis ◽  
Cranial Approach

A modified caudal-to-cranial approach to perform laparoscopic left colectomy for benign diseases has been recently designed to facilitate the low-tie mesenteric dissection. A chart review has been performed including all consecutive patients with uncomplicated diverticulitis who have been treated by segmental left colectomy with a caudal-to-cranial approach. A total of 34 patients were included in the study. 21 patients were male, mean age was 54.1 ± 11.3 , and mean BMI was 26 ± 5.5 . Patients with ASA Score I were 7, with ASA II were 9, and with ASA Score III were 5. Incontinence Score (IS) resulted in an average of 5 ± 2 , 2 grade of incontinence and the CS score showed an average of 10 ± 3 , 2 grade of constipation. Health status, evaluated by Short Form-36 questionnaire, was demonstrated in these patients’ great physical function, role, general health, and social function. The anorectal manometry performed 6 months after surgery showed a normal value in terms of the anal resting pressure ( 47 ± 13  mmHg) and an increased volume to stimulate desire to defecate ( 197 ± 25  ml). The length of the anal sphincter was normal compared to the reference value ( 37 ± 5.4  mm). Although further studies are required to obtain definitive conclusions, our results are encouraging to propose low-tie segmental colectomy as the standard procedure for the treatment of uncomplicated diverticulitis, and our modified surgical approach could be considered useful to facilitate the surgical approach.

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