Long-term incontinence rates after traditional lateral internal sphincterotomy: a 5-year retrospective analysis from a high-volume tertiary referral center for proctologic disorders.
A Realis Luc, A Di Vittori, A Salvatore, G Gravante, V De Simone, A Micarelli, G Clerico, M Trompetto, G Gallo
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引用次数: 0
Abstract
Background: Chronic anal fissures (CAF) are a common proctological condition that significantly impacts patients' quality of life. Lateral internal sphincterotomy (LIS) is widely considered the gold-standard treatment for CAF; however, postoperative fecal incontinence remains a potential risk. The aim of this study is to evaluate long-term incontinence rates following traditional LIS for CAF.
Methods: A retrospective analysis was conducted on patients with CAF who underwent traditional LIS. Patients with any degree of continence impairment prior to surgery, as well as those who experienced events potentially affecting continence function after surgery, were excluded from the analysis. Incontinence was assessed using the Vaizey score both preoperatively and at follow-up.
Results: Between January 2014 and May 2019, 98 patients met the inclusion criteria. The mean follow-up duration was 7 years (range 5-10 years). At follow-up, the Vaizey score ranged from 1 to 4 in 19 patients (19.4%) and from 5 to 9 in 5 patients (5.1%). Incontinence primarily involved gas or liquid stool; no patients reported solid stool incontinence. A total of four patients (4.1%) experienced defecatory urgency. No patients required constipating medications or reported lifestyle changes; only one patient (1.0%) required the use of pads. No correlation was found with age, sex, BMI, or smoking status.
Conclusions: When present, incontinence following traditional LIS is generally mild, does not require constipating medications, and does not interfere with patients' lifestyle.
期刊介绍：
Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.
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