Related Experiment Videos
[Fecal incontinence. Personal experience in direct sphincteric repair]
F Di Bella1, G F Blanco, M Giordano
1Servizio Autonomo di Proctologia Chirurgica, Azienda Ospedaliera, Ospedale S. Martino, Genova, Italy.
Minerva Chirurgica
|July 19, 2001
Summary
Direct sphincter repair effectively restored fecal continence in most patients with post-traumatic anal sphincter injuries. This surgical approach offers significant relief from a disabling condition when pudendal neuropathy is absent.
Area of Science:
- Gastroenterology and Colorectal Surgery
- Anal Sphincter Reconstruction
- Fecal Incontinence Treatment
Context:
- Fecal incontinence is a debilitating condition often underreported due to patient reluctance and distrust in surgical outcomes.
- Traumatic anal sphincter injuries, including those from impalement, obstetrics, or fistulectomy, can lead to significant functional impairment.
- Evaluating the true incidence of fecal incontinence is challenging due to its sensitive nature and varying patient trust in treatment options.
Purpose:
- To report the surgical experience with direct sphincter repair for post-traumatic fecal incontinence.
- To assess the efficacy of direct sphincteric reconstruction in restoring anal continence.
- To evaluate postoperative manometric outcomes and patient recovery following the procedure.
Summary:
- Seven patients with post-traumatic fecal incontinence underwent direct sphincter repair between 1981 and 2000.
- The procedure involved identifying and reconnecting severed sphincter ends, with all patients receiving total parenteral nutrition postoperatively.
- Excellent results, including complete continence recovery and normalized manometric pressures, were achieved in five patients without operative wound infection.
Impact:
- Direct sphincteroplasty can successfully restore satisfactory continence in patients with isolated traumatic anal sphincter lesions, significantly improving quality of life.
- The study highlights the potential of surgical intervention to alleviate the disabling effects of fecal incontinence.
- Further attention to instrumental diagnostics and therapeutic options, including surgical techniques like direct sphincteroplasty, is warranted for fecal incontinence management.