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Anal sphincter reconstruction in the elderly: does advancing age affect outcome?
C Simmang1, E H Birnbaum, I J Kodner
1Washington University School of Medicine, St. Louis, Missouri.
Diseases of the Colon and Rectum
|November 1, 1994
Summary
Advancing age does not negatively impact outcomes for anal sphincter reconstruction. Elderly patients undergoing this surgery show significant functional improvements, with most achieving better control.
Area of Science:
- Colorectal surgery
- Geriatric surgery
- Pelvic floor disorders
Background:
- Anal sphincter dysfunction affects quality of life.
- Surgical repair is an option for fecal incontinence.
- The impact of advanced age on surgical outcomes requires investigation.
Purpose of the Study:
- To evaluate the efficacy of anal sphincter reconstruction in patients aged 55 and older.
- To determine if advanced age adversely affects functional outcomes after this procedure.
Main Methods:
- Retrospective review of 14 patients (55-81 years) undergoing overlapping muscle repair for anal sphincter reconstruction.
- Functional outcomes assessed, with a subgroup undergoing anal manometry and pudendal nerve terminal motor latency (PNTML) testing.
- Comparison with a younger patient cohort.
Main Results:
- 13 of 14 elderly patients experienced functional improvement.
- Complete fecal continence was achieved in 50% of patients.
- Improved maximum squeezing pressure and anal sphincter length correlated with better outcomes; normal PNTML was associated with successful repair.
Conclusions:
- Anal sphincter reconstruction is a viable and effective option for elderly patients with fecal incontinence.
- Successful outcomes are linked to adequate pudendal nerve function and restoration of sphincter pressure.