Document Detail


The role of sphincteroplasty for fecal incontinence reevaluated: a prospective physiologic and functional review.
MedLine Citation:
PMID:  1991416     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Sixteen female patients (mean age 54.1 years; range 34-74 years) with a 9.8-year (range 1-25 years) history of incontinence to solid stool underwent overlapping sphincteroplasty with internal sphincter imbrication without fecal diversion. All patients were prospectively evaluated with preoperative anorectal manometry, electromyography, and pudendal nerve motor latency assessment, postoperative anorectal manometry, and preoperative and postoperative functional evaluation. Mean and maximal resting pressures increased from 30 mm Hg and 49 mm Hg preoperatively to 40 mm Hg and 57 mm Hg, respectively, postoperatively. Likewise, mean and maximal squeeze pressures increased from 27 mm Hg and 48 mm Hg preoperatively to 39 mm Hg and 73 mm Hg, respectively, postoperatively (P less than 0.01). Furthermore, anal canal high pressure zone length was increased by sphincteroplasty from a mean of 0.9 cm (range 0-3 cm) to a mean of 2.1 cm (range 1-4 cm). These objective physiologic improvements correlated well with subjective functional improvement. Subjectively, functional outcome was rated by patients as excellent in 38 percent, good in 38 percent, fair in 19 percent, and poor in only 5 percent of cases. Overlapping sphincteroplasty with internal sphincter imbrication improves both the anal sphincter physiologic profile and fecal continence.
Authors:
S D Wexner; F Marchetti; D G Jagelman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Diseases of the colon and rectum     Volume:  34     ISSN:  0012-3706     ISO Abbreviation:  Dis. Colon Rectum     Publication Date:  1991 Jan 
Date Detail:
Created Date:  1991-03-11     Completed Date:  1991-03-11     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372764     Medline TA:  Dis Colon Rectum     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  22-30     Citation Subset:  IM    
Affiliation:
Department of Colorectal Surgery, Cleveland Clinic Florida, Fort Lauderdale.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anal Canal / injuries,  innervation,  physiopathology*,  surgery*
Blood Loss, Surgical
Electromyography
Evaluation Studies as Topic
Fecal Incontinence / etiology,  physiopathology*,  surgery*
Female
Follow-Up Studies
Humans
Manometry
Middle Aged
Pressure
Prospective Studies
Surgical Procedures, Operative / methods

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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