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Sphincteroplasty

  • James W. OgilvieJr.
  • Robert D. Madoff
  • Donato F. Altomare

Abstract

Fecal incontinence, as a result of trauma to the muscular sphincter complex, has long been surgically treated by approximation of healthy muscular edges on either side of the defect. In his 1923 textbook, Lockhart-Mummery described the operative procedure of mobilizing muscle lateral to the defect and sewing the “ends firmly in contact” [1]. Operative success was “usually most satisfactory,” yet contingent on “proper antiseptic precautions” and “carefully performed” technique. In 1940, however, Blaisdell reported general dissatisfaction among American proctologists with this classic “plastic repair” due to infectious complications, technical challenges, and poor outcomes [2]. Blaisdell went on to describe two techniques that involved overlapping muscle edges while leaving the scarred portion of the sphincter intact. The “reefing operation” brought together muscle opposite the site of damage to narrow the circumference of the anal outlet and thus avoid manipulation of the damaged portion of the sphincter [2].

Keywords

Fecal Incontinence Anal Sphincter Anal Incontinence Sphincter Defect Perineal Body 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Lockhart-Mummery JP (1923) Diseases of the rectum & colon and their surgical treatment. Macmillan, TorontoGoogle Scholar
  2. 2.
    Blaisdell PC (1942) Repair of the incontinent sphincter ani. Surg Gynec Obst 70:692–697Google Scholar
  3. 3.
    Blaisdell PC (1950) Plastic repair of the incontinent sphincter ani. Am J Surg 79:174–183PubMedCrossRefGoogle Scholar
  4. 4.
    Parks AG, McPartlin JF (1971) Late repair of injuries of the anal sphincter. Proc R Soc Med 64:1187–1189PubMedGoogle Scholar
  5. 5.
    Slade MS, Goldberg SM, Schottler JL et al (1977) Sphincteroplasty for acquired anal incontinence. Dis Colon Rectum 20:33–35PubMedCrossRefGoogle Scholar
  6. 6.
    Fernando R, Sultan AH, Kettle C et al (2006) Methods of repair for obstetric anal sphincter injury. Cochrane Database Syst Rev 3:CD002866PubMedGoogle Scholar
  7. 7.
    Sultan AH, Kamm MA, Hudson CN et al (1994) Third degree obstetric anal sphincter tears: risk factors and outcome of primary repair. BMJ 308:887–891PubMedGoogle Scholar
  8. 8.
    Cook TA, Mortensen NJ (1998) Management of faecal incontinence following obstetric injury. Br J Surg 85:293–299PubMedCrossRefGoogle Scholar
  9. 9.
    Gilliland R, Altomare DF, Moreira H Jr et al (1998) Pudendal neuropathy is predictive of failure following anterior overlapping sphincteroplasty. Dis Colon Rectum 41:1516–1522PubMedCrossRefGoogle Scholar
  10. 10.
    Oliveira L, Pfeifer J, Wexner SD (1996) Physiological and clinical outcome of anterior sphincteroplasty. Br J Surg 83:502–505PubMedCrossRefGoogle Scholar
  11. 11.
    Simmang C, Birnbaum EH, Kodner IJ et al (1994) Anal sphincter reconstruction in the elderly: does advancing age affect outcome? Dis Colon Rectum 37:1065–1069PubMedCrossRefGoogle Scholar
  12. 12.
    Sangwan YP, Coller JA, Barrett RC et al (1996) Unilateral pudendal neuropathy. Impact on outcome of anal sphincter repair. Dis Colon Rectum 39:686–689PubMedCrossRefGoogle Scholar
  13. 13.
    Chen AS, Luchtefeld MA, Senagore AJ et al (1998) Pudendal nerve latency. Does it predict outcome of anal sphincter repair? Dis Colon Rectum 41:1005–1009PubMedCrossRefGoogle Scholar
  14. 14.
    Nikiteas N, Korsgen S, Kumar D et al (1996) Audit of sphincter repair. Factors associated with poor outcome. Dis Colon Rectum 39:1164–1170PubMedCrossRefGoogle Scholar
  15. 15.
    Young CJ, Mathur MN, Eyers AA et al (1998) Successful overlapping anal sphincter repair: relationship to patient age, neuropathy, and colostomy formation. Dis Colon Rectum 41:344–349PubMedCrossRefGoogle Scholar
  16. 16.
    Richard C, Bernard D, Morgan S et al (1994) [Results of anal sphincteroplasty for post-traumatic incontinence: with or without colostomy]. Ann Chir 48:703–707PubMedGoogle Scholar
  17. 17.
    Fazio VW, Church JM, Delaney CP (eds) (2005) Current therapy in colon and rectal surgery, 2nd edn. Elsevier Mosby, Philadelphia, pp 108–109Google Scholar
  18. 18.
    Nicholls RJ, Dozois RR (eds) (1997) Surgery of the colon & rectum. Churchill Livingstone, New York, p 75Google Scholar
  19. 19.
    Nessim A, Wexner SD, Agachan F et al (1999) Is bowel confinement necessary after anorectal reconstructive surgery? A prospective, randomized, surgeon-blinded trial. Dis Colon Rectum 42:16–23PubMedCrossRefGoogle Scholar
  20. 20.
    Malouf AJ, Norton CS, Engel AF et al (2000) Longterm results of overlapping anterior anal-sphincter repair for obstetric trauma. Lancet 355:260–265PubMedCrossRefGoogle Scholar
  21. 21.
    Halverson AL, Hull TL (2002) Long-term outcome of overlapping anal sphincter repair. Dis Colon Rectum 45:345–348PubMedCrossRefGoogle Scholar
  22. 22.
    Bravo Gutierrez A, Madoff RD, Lowry AC et al (2004) Long-term results of anterior sphincteroplasty. Dis Colon Rectum 47:727–731; discussion 731–732PubMedCrossRefGoogle Scholar
  23. 23.
    Browning GG, Motson RW (1983) Results of Parks operation for faecal incontinence after anal sphincter injury. Br Med J (Clin Res Ed) 286:1873–1875CrossRefGoogle Scholar
  24. 24.
    Fang DT, Nivatvongs S, Vermeiden FD et al (1984) Overlapping sphincteroplasty for acquired anal incontinence. Dis Colon Rectum 27:720–722PubMedCrossRefGoogle Scholar
  25. 25.
    Christiansen J, Pedersen IK (1987) Traumatic anal incontinence. Results of surgical repair. Dis Colon Rectum 30:189–191PubMedCrossRefGoogle Scholar
  26. 26.
    Pezim ME, Spencer RJ, Stanhope CR et al (1987) Sphincter repair for fecal incontinence after obstetrical or iatrogenic injury. Dis Colon Rectum 30:51–525Google Scholar
  27. 27.
    Stern H, Gallinger S, Rabau M et al (1987) Surgical treatment of anal incontinence. Can J Surg 30:348–350PubMedGoogle Scholar
  28. 28.
    Ctercteko GC, Fazio VW, Jagelman DG et al (1988) Anal sphincter repair: a report of 60 cases and review of the literature. Aust N Z J Surg 58:703–710PubMedGoogle Scholar
  29. 29.
    Abcarian H, Orsay CP, Pearl RK et al (1989) Traumatic cloaca. Dis Colon Rectum 32:783–787PubMedCrossRefGoogle Scholar
  30. 30.
    Yoshioka K, Keighley MR (1989) Sphincter repair for fecal incontinence. Dis Colon Rectum 32:39–42PubMedCrossRefGoogle Scholar
  31. 31.
    Fleshman JW, Peters WR, Shemesh EI et al (1991) Anal sphincter reconstruction: anterior overlapping muscle repair. Dis Colon Rectum 34:739–743PubMedCrossRefGoogle Scholar
  32. 32.
    Gibbs DH, Hooks VH, 3rd (1993) Overlapping sphincteroplasty for acquired anal incontinence. South Med J 86:1376–1380PubMedCrossRefGoogle Scholar
  33. 33.
    Engel AF, Kamm MA, Sultan AH et al (1994) Anterior anal sphincter repair in patients with obstetric trauma. Br J Surg 81:1231–1234PubMedCrossRefGoogle Scholar
  34. 34.
    Londono-Schimmer EE, Garcia-Duperly R, Nicholls RJ et al (1994) Overlapping anal sphincter repair for faecal incontinence due to sphincter trauma: five year follow-up functional results. Int J Colorectal Dis 9:110–113PubMedCrossRefGoogle Scholar
  35. 35.
    Sangalli MR, Marti MC (1994) Results of sphincter repair in postobstetric fecal incontinence. J Am Coll Surg 179:583–586PubMedGoogle Scholar
  36. 36.
    Felt-Bersma RJ, Cuesta MA, Koorevaar M (1996) Anal sphincter repair improves anorectal function and endosonographic image. A prospective clinical study. Dis Colon Rectum 39:878–885PubMedCrossRefGoogle Scholar
  37. 37.
    Sitzler PJ, Thomson JP (1996) Overlap repair of damaged anal sphincter. A single surgeon’s series. Dis Colon Rectum 39:1356–1360PubMedCrossRefGoogle Scholar
  38. 38.
    Karoui S, Leroi AM, Koning E et al (2000) Results of sphincteroplasty in 86 patients with anal incontinence. Dis Colon Rectum 43:813–820PubMedCrossRefGoogle Scholar
  39. 39.
    Osterberg A, Edebol Eeg-Olofsson K, Graf W (2000) Results of surgical treatment for faecal incontinence. Br J Surg 87:1546–1552PubMedCrossRefGoogle Scholar
  40. 40.
    Morren GL, Hallbook O, Nystrom PO et al (2001) Audit of anal-sphincter repair. Colorectal Dis 3:17–22PubMedCrossRefGoogle Scholar
  41. 41.
    Pinta T, Kylanpaa-Back ML, Salmi T et al (2003) Delayed sphincter repair for obstetric ruptures: analysis of failure. Colorectal Dis 5:73–78PubMedCrossRefGoogle Scholar
  42. 42.
    Barisic GI, Krivokapic ZV, Markovic VA et al (2006) Outcome of overlapping anal sphincter repair after 3 months and after a mean of 80 months. Int J Colorectal Dis 21:52–56PubMedCrossRefGoogle Scholar

References

  1. 1.
    Londono-Schimmer EE, Garcia-Duperly R, Nicholls RJ et al (1994) Overlapping anal sphincter repair for faecal incontinence due to sphincter trauma: five year follow-up functional results. Int J Colorectal Dis 9:110–113PubMedCrossRefGoogle Scholar
  2. 2.
    Barisic GI, Krivokapic ZV, Markovic VA, Popovic MA (2006) Outcome of overlapping anal sphincter repair after 3 months and after a mean of 80 months. Int J Colorectal Dis 21:52–56PubMedCrossRefGoogle Scholar
  3. 3.
    Gilliland R, Altomare DF, Moreira H Jr et al (1998) Pudendal neuropathy is predictive of failure following anterior overlapping sphincteroplasty. Dis Colon Rectum 41:1516–1522PubMedCrossRefGoogle Scholar
  4. 4.
    Sangwan YP, CollerJA, Barrett RC et al (1996) Unilateral pudendal neuropathy. Impact on outcome of anal sphincter repair. Dis Colon Rectum 39:686–689PubMedCrossRefGoogle Scholar
  5. 5.
    Chen AS, Luchtefeld MA, Senagore AJ et al (1998) Pudendal nerve latency. Does it predict outcome of anal sphincter repair? Dis Colon Rectum 41:1005–1009PubMedCrossRefGoogle Scholar
  6. 6.
    Buie WD, Lowry AC, Rothenberger DA, Madoff RD (2001) Clinical rather than laboratory assessment predicts continence after anterior sphincteroplasty. Dis Colon Rectum 44:1255–1260PubMedCrossRefGoogle Scholar
  7. 7.
    Conaghan P, Farouk R (2005) Sacral nerve stimulation can be successful in patients with ultrasound evidence of external anal sphincter disruption. Dis Colon Rectum 48:1610–1614PubMedCrossRefGoogle Scholar
  8. 8.
    Giordano P, Renzi A, Efron J et al (2002) Previous sphincter repair does not affect the outcome of repeat repair. Dis Colon Rectum 45:635–640PubMedCrossRefGoogle Scholar
  9. 9.
    Vaizey CJ, Norton C, Thornton MJ et al (2004) Long-term results of repeat anterior anal sphincter repair. Dis Colon Rectum 47:858–863PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2007

Authors and Affiliations

  • James W. OgilvieJr.
  • Robert D. Madoff
  • Donato F. Altomare

There are no affiliations available

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