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Sphincter repair without overlapping for fecal incontinence
A Arnaud1, J C Sarles, I Sielezneff
1Department of Digestive Surgery, Hopital Sainte-Marguerite, Université d'Aix Marseille II, France.
Diseases of the Colon and Rectum
|September 1, 1991
Summary
Sphincter repair surgery for anal incontinence showed good results, with 25 of 40 patients achieving full continence. The study suggests that overlapping sutures and diverting colostomy are not always necessary for successful anal sphincter repair.
Area of Science:
- Colorectal Surgery
- Gastroenterology
- Pelvic Floor Disorders
Background:
- Anal sphincter trauma can lead to significant fecal incontinence.
- Previous repair attempts and various etiologies (surgery, childbirth, accidents) complicate treatment.
- Surgical repair aims to restore anal sphincter function and improve quality of life.
Purpose of the Study:
- To evaluate the outcomes of a specific sphincter repair technique.
- To determine the necessity of overlapping sutures and diverting colostomy in anal sphincter repair.
- To analyze factors influencing successful surgical outcomes for fecal incontinence.
Main Methods:
- Retrospective review of 40 patients undergoing anal sphincter repair by a single surgeon over 15 years.
- Analysis of patient history, etiology of trauma, and prior repair attempts.
- Assessment of surgical technique (non-overlapping sutures) and use of diverting colostomy in select cases.
Main Results:
- Overall, 25 patients (62.5%) achieved complete continence post-surgery.
- 6 patients experienced occasional liquid stool leakage, and 4 were continent for solid stool only.
- No significant improvement was observed in 5 patients; 11 had prior repair failures.
Conclusions:
- Sphincter repair without overlapping sutures can be effective in treating fecal incontinence.
- Diverting colostomy may not be mandatory, even in patients with previous failed repairs.
- Successful anal sphincter repair is achievable with careful patient selection and surgical technique.