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 a fascial sling or direct end-to-end repair of the disrupted sphincter result in a high failure rate. Failure after direct end-to-end repair is usually caused by break down of the suture line owing to retraction of the muscle ends [3]. Parks advocated an overlapping repair [4] in which the disrupted ends of the sphincter were mobilised and wrapped around each other. This paper reports the results of overlapping sphincter repair for faecal incontinence resulting from trauma, after a 5 year follow-up period.
Résumé
Une rupture de l'anneau sphinctérien anal peut résulter de lésions obstétricales, de séquelles d'interventions chirurgicales et de lésions traumatiques. Les ruptures obstétricales ou chirurgicales du sphincter peuvent ne pas être immédiatement apparentes et le développement clinique de l'incontinence peut survenir plusieurs années après la lésion. La reconstruction du sphincter avec un lambeau de fascia ou la réparation directe bord à bord du sphincter rompu se soldent par un taux élevé d'échecs. L'échec après suture bord à bord est dû à la desunion de la suture en raison d'une rétraction des extrémités musculaires. Parks avait recommandé une suture en gilet dans laquelle les deux extrémités du sphincter rompu sont mobilisées et suturées après chevauchement. Cet article rapporte le follow-up à 5 ans de ruptures sphinctériennes d'origine traumatique traitées par chevauchement des extrémités sphinctériennes.
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Londono-Schimmer, E.E., Garcia-Duperly, R., Nicholls, R.J. et al. Overlapping anal sphincter repair for faecal incontinence due to sphincter trauma: five year follow-up functional results. Int J Colorect Dis 9, 110–113 (1994). https://doi.org/10.1007/BF00699424
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DOI: https://doi.org/10.1007/BF00699424