Update on surgical treatment for sphincter repair in fecal incontinence. When to do it and why?

2021 ◽  
Vol 32 (3) ◽  
pp. 403-404
Author(s):  
F de la Portilla de Juan
2021 ◽  
Vol 34 (01) ◽  
pp. 040-048
Author(s):  
Srinivas Joga Ivatury ◽  
Lauren R. Wilson ◽  
Ian M. Paquette

AbstractFecal incontinence is a prevalent health problem that affects over 20% of healthy women. Many surgical treatment options exist for fecal incontinence after attempts at non-operative management. In this article, the authors discuss surgical treatment options for fecal incontinence other than sacral neuromodulation.


Author(s):  
F. Litta ◽  
A. Parello ◽  
L. Ferri ◽  
N. O. Torrecilla ◽  
A. A. Marra ◽  
...  

Abstract Background Simple anal fistula is one of the most common causes of proctological surgery and fistulotomy is considered the gold standard. This procedure, however, may cause complications. The aim of this systematic review was to assess the surgical treatment of simple anal fistula with traditional and sphincter-sparing techniques. Methods A literature research was performed using PubMed, Cochrane, and Google Scholar to identify studies on the surgical treatment of simple anal fistulas. Observational studies and randomized clinical trials were included. We assessed the risk of bias of included studies using the Jadad scale for randomized controlled trials, and the MINORS Scale for the remaining studies. Results The search returned 456 records, and 66 studies were found to be eligible. The quality of the studies was generally low. A total of 4883 patients with a simple anal fistula underwent a sphincter-cutting procedure, mainly fistulotomy, with a weighted average healing rate of 93.7%, while any postoperative continence impairment was reported in 12.7% of patients. Sphincter-sparing techniques were adopted to treat 602 patients affected by simple anal fistula, reaching a weighted average success rate of 77.7%, with no study reporting a significant postoperative incontinence rate. The postoperative onset of fecal incontinence and the recurrence of the disease reduced patients’ quality of life and satisfaction. Conclusions Surgical treatment of simple anal fistulas with sphincter-cutting procedures provides excellent cure rates, even if postoperative fecal incontinence is not a negligible risk. A sphincter-sparing procedure could be useful in selected patients.


2009 ◽  
Vol 52 (6) ◽  
pp. 1089-1094 ◽  
Author(s):  
Massarat Zutshi ◽  
Tracy Hull ◽  
Jane Bast ◽  
Amy Halverson ◽  
Jeanie Na

2004 ◽  
Vol 59 (4) ◽  
pp. 168-171 ◽  
Author(s):  
Carlos Walter Sobrado ◽  
Desidério Roberto Kiss ◽  
Sérgio C. Nahas ◽  
Sérgio E. A. Araújo ◽  
Victor E. Seid ◽  
...  

The "best" surgical technique for the management of complete rectal prolapse remains unknown. Due to its low incidence, it is very difficult to achieve a representative number of cases, and there are no large prospective randomized trials to attest to the superiority of one operation over another. PURPOSE: Analyze the results of surgical treatment of complete rectal prolapse during 1980 and 2002. METHOD: Retrospective study. RESULTS: Fifty-one patients underwent surgical treatment during this period. The mean age was 56.7 years, with 39 females. Besides the prolapse itself, 33 patients complained of mucous discharge, 31 of fecal incontinence, 14 of constipation, 17 of rectal bleeding, and 3 of urinary incontinence. Abdominal operations were performed in 36 (71%) cases. Presacral rectopexy was the most common abdominal procedure (29 cases) followed by presacral rectopexy associated with sigmoidectomy (5 cases). The most common perineal procedure was perineal rectosigmoidectomy associated with levatorplasty (12 cases). Intraoperative bleeding from the presacral space developed in 2 cases, and a rectovaginal fistula occurred in another patient after a perineal rectosigmoidectomy. There were 2 recurrences after a mean follow-up of 49 months, which were treated by reoperation. CONCLUSION: Abdominal and perineal procedures can be used to manage complete rectal prolapse with safety and good long-term results. Age, associated medical conditions, and symptoms of fecal incontinence or constipation are the main features that one should bear in mind in order to choose the best surgical approach.


2007 ◽  
Vol 189 (2) ◽  
pp. W70-W77 ◽  
Author(s):  
Annette C. Dobben ◽  
Maaike P. Terra ◽  
Marije Deutekom ◽  
J. Frederik M. Slors ◽  
Lucas W. M. Janssen ◽  
...  

1995 ◽  
Vol 127 (6) ◽  
pp. 954-957 ◽  
Author(s):  
Anthony G. Catto-Smith ◽  
Carolyn M.M. Coffey ◽  
Terence M. Nolan ◽  
John M. Hutson

2000 ◽  
Vol 17 (4) ◽  
pp. 390-394 ◽  
Author(s):  
J. Rothbarth ◽  
W.A. Bemelman ◽  
W.J.H.J. Meijerink ◽  
M.E. Buyze-Westerweel ◽  
J.G. van Dijk ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document