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[Fecal incontinence. What to do?]
M Gonçalves1, J Mendes, M J Leal
1Serviço de Cirurgia Pediátrica, Hospital St. Maria, Lisboa.
Acta Medica Portuguesa
|December 1, 1994
Summary
This study explores surgical techniques for fecal incontinence, demonstrating that muscle repair and reconstruction can significantly improve continence in patients with various defecation disorders.
Area of Science:
- Colorectal Surgery
- Gastroenterology
- Pelvic Floor Disorders
Background:
- Functional and organic pathologies can impair the defecation mechanism.
- Fecal incontinence presents a significant challenge in managing defecation disorders.
Purpose of the Study:
- To evaluate the efficacy of a specific surgical technique for fecal incontinence.
- To present clinical cases and surgical outcomes for patients with defecation dysfunction.
Main Methods:
- Four cases of fecal incontinence were analyzed: false encopresis, myelomeningocele, and ileo-anal anastomosis.
- Surgical intervention involved myorrhaphy of rectal levators and gluteal muscle plasty with approximation and median suture.
- Manometric evaluation was performed pre-operatively.
Main Results:
- Three out of four patients showed significant improvement in fecal continence post-surgery.
- One case (myelomeningocele) experienced complications including an abscess and suture dehiscence, leading to a less satisfactory outcome.
- The surgical technique is described as straightforward, utilizing adjacent muscle groups to enhance continence.
Conclusions:
- The described surgical approach, involving rectal levator myorrhaphy and gluteal muscle plasty, offers a viable option for improving fecal continence.
- Careful patient selection and management are crucial, as demonstrated by the varied outcomes in the presented cases.