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Fecal incontinence and anorectal surgery and quality of life

Ted M Roth
BACKGROUND: Paradoxical puborectalis contraction (PPC) is a syndrome of obstructed defecation associated with a cluster of complaints including rectal pain, incomplete evacuatory sensation, prolonged repetitive straining with bowel movements, and the need for digital manipulation. Traditional treatment has yielded mixed results. CASE: We present a case of PPC successfully treated with staged sacral neuromodulation and review her diagnostic features, medical regimen, and prior unsuccessful interventions tried...
March 21, 2018: Female Pelvic Medicine & Reconstructive Surgery
M Schiano di Visconte, G A Santoro, N Cracco, G Sarzo, G Bellio, M Brunner, Z Cui, K E Matzel
BACKGROUND: To assess whether sacral nerve stimulation (SNS) is an effective treatment for severe fecal incontinence (FI) after radiotherapy (RT)/chemoRT (CRT) in combination with pelvic surgery. METHODS: A multicenter study was conducted on patients with FI that developed after multimodal therapy for pelvic tumors and was refractory to non-operative management, who were treated with SNS between November 2009 and November 2012. Data were prospectively collected and retrospectively analyzed...
February 2018: Techniques in Coloproctology
P L Lu, I J N Koppen, D K Orsagh-Yentis, K Leonhart, E J Ambeba, K J Deans, P C Minneci, S Teich, K A Diefenbach, S A Alpert, M A Benninga, D Yacob, C Di Lorenzo
OBJECTIVE: To evaluate the long-term efficacy of sacral nerve stimulation (SNS) in children with constipation and describe patient benefit and parent satisfaction. METHODS: Using a prospective patient registry, we identified patients <21 years old with constipation treated with SNS for >2 years. We compared symptoms, medical treatment, PedsQL Gastrointestinal Symptom Scale (GSS), Fecal Incontinence Quality of Life Scale (FIQL), and Fecal Incontinence Severity Index (FISI) before SNS and at follow-up...
February 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Lei Chen, Fanqi Meng, Tongsen Zhang, Yinan Liu, Shuang Sha, Si Chen, Jiandong Tai
OBJECTIVE: To investigate the clinical efficacy and safety of modified stapled transanal rectal resection (STARR) combined with perioperative pelvic floor biofeedback therapy (POPFBFT) in treating obstructed defecation syndrome (ODS). METHODS: Thirty female ODS patients underwent modified STARR (resection and suture was performed in rectocele with one staple) combined with POPFBFT in Department of Colorectal and Anal Surgery, The First Hospital of Jilin university from October 2013 to March 2015...
May 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Prince Raj, Yogesh Kumar Sarin, Prachi Raj
BACKGROUND: Anorectal malformation (ARM) is one of the most common pediatric surgical problems dealt in day-to-day practice. Although the outcome of surgery has improved a great deal over the last three decades fecal incontinence (FI) is still a common long-term morbidity that affects the quality of life of these patients. Bowel wash (BW) program with pelvic floor exercise are standard care of management for these patients. This study was undertaken to assess the role of interferential therapy (IFT) along with BW compared to BW alone in the management of FI...
April 2017: Journal of Indian Association of Pediatric Surgeons
Patricio B Lynn, Lindsay A Renfro, Xiomara W Carrero, Qian Shi, Paul L Strombom, Oliver Chow, Julio Garcia-Aguilar
BACKGROUND: Little is known about anorectal function and quality of life after chemoradiation followed by local excision, which is an alternative to total mesorectal excision for selected patients with early rectal cancer. OBJECTIVE: The purpose of this study was to prospectively assess anorectal function and health-related quality of life of patients with T2N0 rectal cancer who were treated with an alternative approach. DESIGN: This was a prospective, phase II trial...
May 2017: Diseases of the Colon and Rectum
Roberto Ghiselli, Monica Ortenzi, Luca Cardinali, Edlira Skrami, Rosaria Gesuita, Mario Guerrieri
BACKGROUND: In patients who exhibit a complete clinical response after radio-chemotherapy for rectal cancer, the standard surgical approach might constitute overtreatment. The aim of this study is to analyse the outcomes of anorectal function and quality of life after transanal endoscopic microsurgery (TEM) in irradiated patients with complete clinical response. PATIENTS AND METHODS: Between 2007 and 2014, 84 patients who were diagnosed with stage T2-T3-T4 N0 rectal cancer before chemoradiotherapy showed a complete clinical response to neoadjuvant therapy and underwent TEM...
July 2017: Surgical Endoscopy
F Cour, L Le Normand, G Meurette
OBJECTIVE: The aim was to review the safety and efficacy of surgery for posterior vaginal wall prolapse by vaginal route, in order to identify a therapeutic algorithm based on benefit/risk evaluation of each surgical procedure. MATERIAL AND METHODS: We performed a review of the litterature published up to september 2015 (PubMed, Medline, Cochrane library, Cochrane database of systemactic reviews) according to the HAS methodology. Level evidence (1 to 4) was determined for each study as well as evidence based recommendations (A, B, C or professional agreement)...
July 2016: Progrès en Urologie
Angelita Habr-Gama, Patricio B Lynn, J Márcio N Jorge, Guilherme P São Julião, Igor Proscurshim, Joaquim Gama-Rodrigues, Laura M Fernandez, Rodrigo O Perez
BACKGROUND: Organ-preserving strategies have been considered for patients with distal rectal cancer and complete or near-complete response to neoadjuvant chemoradiation to avoid the functional consequences of radical surgery. Transanal endoscopic microsurgery and no immediate surgery (watch and wait) have been considered in selected patients. OBJECTIVE: The aim of this study is to compare anorectal function following these 2 organ-preserving strategies (transanal endoscopic microsurgery and watch and wait) for rectal cancer with complete or near-complete response to neoadjuvant chemoradiation...
April 2016: Diseases of the Colon and Rectum
Feiteng Kong, Yang Wu, Yongmei Chen, Juxian Liu, Fuyu Li, Bo Xiang
PURPOSE: The aim of the study was to report our 13-year experience of 14 children with gluteus maximus muscular transposition to treat post-trauma fecal incontinence and discuss our technical modifications to this surgical procedure. METHODS: Fourteen children (median age: 9.9years) with complete fecal incontinence after traumas received this procedure from December 1998 to February 2011. The major modification of the surgery was that we transposed two thick muscular bundles about 2cm in diameter bilaterally...
December 2015: Journal of Pediatric Surgery
Jeong-Ki Kim, Byeong Geon Jeon, Yoon Suk Song, Mi Sun Seo, Yoon-Hye Kwon, Ji Won Park, Seung-Bum Ryoo, Seung-Yong Jeong, Kyu Joo Park
PURPOSE: This study prospectively investigated the effects of biofeedback therapy on objective anorectal function and subjective bowel function in patients after sphincter-saving surgery for rectal cancer. METHODS: Sixteen patients who underwent an ileostomy were randomized into two groups, one receiving conservative management with the Kegel maneuver and the other receiving active biofeedback before ileostomy closure. Among them, 12 patients (mean age, 57.5 years; range, 38 to 69 years; 6 patients in each group) completed the study...
August 2015: Annals of Coloproctology
E Aytac, E Gorgun, H H Erem, M A Abbas, T L Hull, F H Remzi
BACKGROUND: We aimed to compare long-term outcomes and quality of life in patients undergoing circular stapled hemorrhoidopexy to those who had Ferguson hemorrhoidectomy. METHODS: Patients who underwent Ferguson hemorrhoidectomy and circular stapled hemorrhoidopexy between 2000 and 2010 were reviewed. Long-term follow-up was assessed with questionnaires. RESULTS: Two hundred seventeen patients completed the questionnaires. Mean follow-up was longer in the Ferguson hemorrhoidectomy subgroups (7...
October 2015: Techniques in Coloproctology
Zerrin Ozgen, Sevgi Ozden, Beste M Atasoy, Hazan Ozyurt, Rasim Gencosmanoglu, Nese Imeryuz
BACKGROUND: There is growing recognition for the consequences of rectal cancer treatment to maintain an adequate functional sphincter in the long-term rather than preserving the anal sphincter itself. This study aims to evaluate long-term effects of neoadjuvant chemoradiotherapy (nCRT) followed by sphincter-preserving resection on anal sphincter function in relation to quality of life (QoL) among locally advanced rectal cancer patients. METHODS: Twenty-nine patients treated with nCRT followed by low anterior resection surgery were included in this study...
2015: Radiation Oncology
Abhijit Chandra, Brijesh Mishra, Saket Kumar, Vishal Gupta, M Noushif, U C Ghoshal, Asha Misra, P K Srivastava
BACKGROUND: Technique and functional outcomes of anorectal reconstruction using an antropyloric graft have been reported previously. This technique had reasonable initial outcomes but lacked voluntary function. OBJECTIVE: We hereby report the initial results of patients who underwent gracilis muscle wrapping around the perineally transposed antropyloric valve in an attempt to improve voluntary fecal control. SETTING: This study was conducted at a single tertiary care institution...
May 2015: Diseases of the Colon and Rectum
Li-Jen Kuo, Yu-Ching Lin, Chien-Hung Lai, Yen-Kuang Lin, Yu-Shih Huang, Chia-Chen Hu, Shih-Ching Chen
OBJECTIVE: To assess the efficacy and benefits of pelvic rehabilitation programs in terms of functional outcomes and quality of life for patients with fecal incontinence and defecation disorders after rectal cancer surgery. DESIGN: Prospective, observational study. SETTING: University hospital physiotherapy clinics. PARTICIPANTS: Patients (N=32) who experienced fecal incontinence after sphincter-saving surgery with the intersphincteric resection (ISR) technique and could follow and cooperate with the treatment schedule were included in the present study...
August 2015: Archives of Physical Medicine and Rehabilitation
Christoph Isbert, Nicolas Schlegel, Joachim Reibetanz, Katica Krajinovic, Karsten Schmidt, Christoph-Thomas Germer, Mia Kim
PURPOSE: Restoration of continence remains a major challenge in patients after abdominoperineal rectal excision (APE) or with end-stage fecal incontinence. A new surgical technique, the neurostimulated levator augmentation, was introduced for pelvic floor augmentation using dynamic graciloplasty in order to restore anorectal angulation. The aim of this study was to assess feasibility and efficiency. METHODS: From November 2009 to March 2014, n = 17 patients underwent neurostimulated levator augmentation (n = 10 after APE, n = 5 intractable idiopathic fecal incontinence, n = 2 traumatic anal amputation)...
April 2015: International Journal of Colorectal Disease
Ajay Narayan Gangopadhyay, Vaibhav Pandey
Anorectal malformations (ARMs) are among the more frequent congenital anomalies encountered in paediatric surgery, with an estimated incidence ranging between 1 in 2000 and 1 in 5000 live births. Antenatal diagnosis of an isolated ARM is rare. Most cases are diagnosed in the early neonatal period. There is a wide spectrum of presentation ranging from low anomalies with perineal fistula having simple management to high anomalies with complex management. Advances in the imaging techniques with improvement in knowledge of the embryology, anatomy and physiology of ARM cases have refined diagnosis and initial management...
January 2015: Journal of Indian Association of Pediatric Surgeons
Adil E Bharucha, Gena Dunivan, Patricia S Goode, Emily S Lukacz, Alayne D Markland, Catherine A Matthews, Louise Mott, Rebecca G Rogers, Alan R Zinsmeister, William E Whitehead, Satish S C Rao, Frank A Hamilton
In August 2013, the National Institutes of Health sponsored a conference to address major gaps in our understanding of the epidemiology, pathophysiology, and management of fecal incontinence (FI) and to identify topics for future clinical research. This article is the first of a two-part summary of those proceedings. FI is a common symptom, with a prevalence that ranges from 7 to 15% in community-dwelling men and women, but it is often underreported, as providers seldom screen for FI and patients do not volunteer the symptom, even though the symptoms can have a devastating impact on the quality of life...
January 2015: American Journal of Gastroenterology
Shuqing Ding
Benign anorectal diseases are common. Hemorrhoids, anal fissure and anal fistula are the top three of colorectal surgery for benign anrorectal clinical practice. Postoperative fecal incontinence or stool seepage has not yet got enough attention by specialists. This article elaborates on the clinical status, evaluation process, functional protection and treatment strategies etc. Following the continence protection principle requires specialists to focus on not only the disease itself but the patient-centered quality of life...
December 2014: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Yihuan Song, Guangen Yang, Jianming Qiu, Xiufeng Zhang, Qun Deng, Dong Wang
OBJECTIVE: To evaluate the impact of transanal endoscopic microsurgery (TEM) on postoperative anal function and quality of life in patients with benign rectal tumor and early rectal cancer. METHODS: Clinical data of 50 patients with rectal adenoma and early rectal cancer undergoing transanal endoscopic microsurgery in our hospital from October 2008 to June 2013 were retrospectively analyzed. Anorectal manometry, endorectal ultrasonography (ERUS), the fecal incontinence severity index (FISI), and the physical and mental health status scores (SF-36) were used to evaluate preoperative and postoperative anorectal function and quality of life...
August 2014: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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