Abstract:
BACKGROUND:Obstetric anal sphincter injury is the most frequent cause of fecal incontinence (FI) in young women. However, the relationship between the extent of anal sphincter defects and the severity of long-term FI (at least 1 year after delivery) has been poorly studied. The aim of the present study was to determine if, in the long term, the extent of anal sphincter defects graded at anal endosonography was linked with the severity of FI. METHODS:A retrospective study was conducted on women with a history of vaginal delivery, who presented with FI and had three-dimensional anorectal high-resolution manometry and endoanal ultrasound in our center from January 2015 to 2016. The detailed clinical history of each patient was obtained from the institutional database. The severity of FI was assessed with the Jorge and Wexner continence scale. RESULTS:There were 250 women with a mean age of 60 ± 14 years. Seventy-six (30.4%) had an isolated defect of the internal anal sphincter, 21 (8.4%) had an isolated defect of the external anal sphincter, and 150 (60%) had both internal and external sphincter defects. The extent of IAS and EAS defects was proportionally correlated with the decrease in mean resting anal pressure (p < 0.01) and the decrease in mean squeeze pressure (p = 0.013) measured by 3DHRAM. No significant correlation was found between the extent and location of the defect (IAS, EAS or both) on endoanal ultrasound and the severity of FI. Menopause was the only independent factor significantly associated with the severity of FI. CONCLUSIONS:In our study, no significant correlation was observed between the extent of the anal sphincter defect and the severity of FI. Menopause was the only identified and independent risk factor for FI. These data confirm that, in the long-term, FI is often multifactorial.
journal_name
Tech Coloproctoljournal_title
Techniques in coloproctologyauthors
Luciano L,Bouvier M,Baumstarck K,Vitton Vdoi
10.1007/s10151-019-02128-1subject
Has Abstractpub_date
2020-01-01 00:00:00pages
49-55issue
1eissn
1123-6337issn
1128-045Xpii
10.1007/s10151-019-02128-1journal_volume
24pub_type
杂志文章abstract:BACKGROUND:Total mesorectal excision (TME) has greatly reduced the local recurrence rate of rectal cancer after colorectal surgery. Transanal TME (TaTME) is potentially a suitable option for patients with mid and low rectal cancer. Robotic systems overcome the limitations of laparoscopic surgery. The aim of this study ...
journal_title:Techniques in coloproctology
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abstract::Hepatic resection for colorectal liver metastases remains the only therapeutic option that improves long-term survival and offers potential cure. By conventional resectability criteria, only a limited number of patients with metastatic disease can be subjected to surgical intervention. In the past decade, better under...
journal_title:Techniques in coloproctology
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journal_title:Techniques in coloproctology
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journal_title:Techniques in coloproctology
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abstract::Endoscopic polypectomy is the gold standard for the treatment of colorectal polyps. In the case of non-palpable lesions or to complete polyp removal, the lesions are located intra-operatively. With the advent of laparoscopy, identifying their position is even more important because there is no opportunity for intestin...
journal_title:Techniques in coloproctology
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abstract::Colorectal cancer (CRC) is the leading cause of cancer-related mortality in western countries. Adjuvant treatment does not seem to be highly effective and recurrent or metastatic disease occurs in half of the new cases within one year of diagnosis and median survival does not exceed 18 months. CRC represents an optima...
journal_title:Techniques in coloproctology
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abstract:BACKGROUND:Technical factors affect oncologic outcomes in rectal cancer surgery. The anatomy of the bony pelvis can affect technical aspects of surgery, but is seldom considered preoperatively. We performed a morphometric analysis of the bony pelvis in patients having rectal cancer resection to assess its effect on sur...
journal_title:Techniques in coloproctology
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abstract::A patient with a metastatic fixed low rectal carcinoma presented severe rectal bleeding requiring massive transfusion over with a 36-hour period. Bleeding was controlled with the instillation of a 4% intrarectal formalin solution permitting the completion of a course of neoadjuvant chemoradiotherapy. This technique ha...
journal_title:Techniques in coloproctology
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doi:10.1007/s10151-005-0193-6
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abstract::Various transanal and perineal surgical techniques have been described for the treatment of rectourethral fistula (RUF). However, these techniques are poorly suited for complicated fistulas. Here, we present a novel minimally invasive procedure: robotic-assisted laparoscopic segmental resection with rectoanal anastomo...
journal_title:Techniques in coloproctology
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doi:10.1007/s10151-012-0913-7
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pub_type: 杂志文章,评审
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abstract:BACKGROUND:Doppler-guided hemorrhoidal artery ligation (DGHAL) was described as lower risk and a less painful alternative to hemorrhoidectomy. We report our experience and 5-year follow-up with this procedure. METHODS:Between May 2003 and December 2004, 100 patients with symptomatic Grade II or III hemorrhoids underwe...
journal_title:Techniques in coloproctology
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abstract:BACKGROUND:Treatment of perforated diverticulitis depends on disease severity classified according to Hinchey's preoperative classification. This study assessed the accuracy of preoperative staging of perforated diverticulitis by computerized tomography (CT) scanning. METHODS:All patients who presented with perforated...
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doi:10.1007/s10151-013-0990-2
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journal_title:Techniques in coloproctology
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doi:10.1007/s10151-014-1181-5
更新日期:2014-11-01 00:00:00
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journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-005-0212-7
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abstract:BACKGROUND:Diverticulitis is a common indication for surgical emergency room admission, often leading to abdominal computed tomography (CT) scanning for both diagnosis and staging. C-reactive protein (CRP) has been identified as a useful biomarker of inflammation. Aspirin and corticosteroids are known to down-regulate ...
journal_title:Techniques in coloproctology
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doi:10.1007/s10151-013-1044-5
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abstract:BACKGROUND:The presence of endometriosis in the anal canal and perianal tissues is rare and difficult to suspect at clinical examination. We report our experience with preoperative ultrasound evaluation of four cases of anal endometriosis. METHODS:Four patients were evaluated by transperineal and high-resolution three...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
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journal_title:Techniques in coloproctology
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journal_title:Techniques in coloproctology
pub_type: 杂志文章
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更新日期:2008-12-01 00:00:00
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journal_title:Techniques in coloproctology
pub_type: 杂志文章
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更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Foramen needle electrode placement for percutaneous nerve evaluation (PNE) is currently carried out while observing the somatic motor response. This study investigated electrode placement while observing the autonomic as well as the somatic response. METHODS:A consecutive series of ten patients (seven women...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-014-1160-x
更新日期:2014-08-01 00:00:00
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journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-013-1016-9
更新日期:2014-04-01 00:00:00
abstract::There is still no clear consensus about surgical treatment of anal fistulas. Fistulotomy or fistulectomy and primary sphincter reconstruction is still regarded with skepticism. The aim of this systematic review was to evaluate the evidence in the literature supporting the use of this technique in the treatment of comp...
journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
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journal_title:Techniques in coloproctology
pub_type: 杂志文章,评审
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更新日期:2005-12-01 00:00:00
abstract:BACKGROUND:The purposes of the study were the long-term evaluation of silicone implants with three-dimensional (3D) anal endosonography and its correlation with anal incontinence. METHODS:Fifteen patients were injected with silicone because of anal incontinence and co-existing internal anal sphincter disruption (n = 8...
journal_title:Techniques in coloproctology
pub_type: 杂志文章
doi:10.1007/s10151-009-0502-6
更新日期:2009-09-01 00:00:00
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更新日期:2013-10-01 00:00:00