COMPARISON OF ANTERIOR SPHINCTEROPLASTY AND POSTANAL REPAIR IN THE TREATMENT OF IDIOPATHIC FECAL INCONTINENCE

被引:45
|
作者
ORROM, WJ [1 ]
MILLER, R [1 ]
CORNES, H [1 ]
DUTHIE, G [1 ]
MORTENSEN, NJM [1 ]
BARTOLO, DCC [1 ]
机构
[1] BRISTOL ROYAL INFIRM & GEN HOSP,DEPT SURG,BRISTOL BS2 8HW,AVON,ENGLAND
关键词
FECAL INCONTINENCE; OPERATIVE TREATMENT; POSTANAL REPAIR; ANTERIOR SPHINCTEROPLASTY; MANOMETRY; ANORECTAL ANGLE; ANAL SENSATION;
D O I
10.1007/BF02050589
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Both postanal repair and anterior sphincteroplasty with levatorplasty have been advocated in the treatment of idiopathic fecal incontinence. To assess the functional results of these procedures, physiologic and radiologic measurements were carried out prospectively in 33 patients with idiopathic incontinence undergoing operative treatment, and 12 age- and sex-matched controls. Sixteen patients had anterior sphincteroplasty and levatorplasty and 17 had postanal repair. A satisfactory postoperative outcome was defined as perfect continence or incontinence of flatus only. Ten patients in the anterior sphincteroplasty group had satisfactory results (64 percent) and 10 in the postanal repair group (59 percent). Preoperatively, both groups had decreased resting and squeeze pressures, impaired anal mucosal electrosensitivity, and marked pelvic descent vs. controls. Postoperatively, significant improvement in sphincter pressures and mucosal electrosensitivity was seen in both groups. No significant change in anorectal angle was demonstrated in the postanal repair group, whereas it was made significantly more obtuse in the anterior sphincteroplasty group. It is likely that the improved continence resulting from either of these two procedures is secondary to better anal sphincter muscle function and improved anal sensation. It would appear that the anorectal angle is not crucial in maintaining continence.
引用
收藏
页码:305 / 310
页数:6
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