Abstract:
PURPOSE:The purpose of this study was to assess the effect of a structured hands-on workshop on the detection rate of obstetric anal sphincter injuries. METHODS:All physicians attending the delivery ward in our institution participated in a structured obstetric anal sphincter injury hands-on workshop developed by Dr. Ranee Thakar and Dr. Abdul Sultan which demonstrated proper identification and techniques for obstetric anal sphincter injury detection and repair. We retrospectively reviewed the electronic records of all singleton-pregnancy women who delivered vaginally (vertex presentation) during the 2 years prior to and 1 year following the workshop to assess the workshop's effect on the rate of detection of obstetric anal sphincter injuries. RESULTS:Overall, 20,484 women met the inclusion criteria during the study period and were eligible for final analysis. There were no significant differences in patient's characteristics between the groups. Women in the pre-workshop group had a higher rate of obstetric anal sphincter injuries than the post-workshop group (0.4 vs. 0.2 %, p = 0.005). On multivariate analysis, factors independently associated with a decreased risk for obstetric anal sphincter injuries were deliveries in the post-workshop period (odds ratio 0.43, 95 % confidence interval 0.24-0.79, p = 0.006), parity (odds ratio 0.37, 95 % confidence interval 0.25-0.54, p < 0.001), and spontaneous vaginal delivery (odds ratio 0.43, 95 % confidence interval 0.26-0.71, p = 0.001). CONCLUSIONS:A proper detection of obstetric anal sphincter injuries may depend on the experience of the assessor. A structured hands-on workshop is important to avoid over diagnosis third-degree perineal tears.
journal_name
Int J Colorectal Disjournal_title
International journal of colorectal diseaseauthors
Krissi H,Aviram A,Hiersch L,Ashwal E,Eitan R,Peled Ydoi
10.1007/s00384-015-2365-9subject
Has Abstractpub_date
2016-01-01 00:00:00pages
45-50issue
1eissn
0179-1958issn
1432-1262pii
10.1007/s00384-015-2365-9journal_volume
31pub_type
杂志文章abstract::This study evaluates anorectal function after combined tele- and brachytherapy for anal cancer using manometric measurements and a standardized questionnaire. Eight patients received 44 +/- 3 Gy external beam radiation followed by 20 +/- 4 Gy interstitial brachytherapy with iridium-192. Patients were examined 43 month...
journal_title:International journal of colorectal disease
pub_type: 临床试验,杂志文章
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pub_type: 临床试验,杂志文章
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journal_title:International journal of colorectal disease
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更新日期:2016-06-01 00:00:00
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pub_type: 杂志文章,评审
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abstract::Disruption of the anal sphincter results from obstetric injury, ano-rectal operations or external trauma. Obstetric or surgical division of the sphincteric mechanism may not be immediately apparent and the clinical presentation of incontinence may occur several years later [1, 2]. Reconstruction of the sphincter using...
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pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:International journal of colorectal disease
pub_type: 杂志文章
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更新日期:1997-01-01 00:00:00
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