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Techniques in Coloproctology
Published in: Techniques in Coloproctology 11/2014

01-11-2014 | Original Article

Suboptimal results after sphincteroplasty: another hazard of obesity

Authors: K. D. Hong, G. DaSilva, J. T. Dollerschell, S. D. Wexner

Published in: Techniques in Coloproctology | Issue 11/2014

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Abstract

Background

This study aimed to investigate the outcomes of sphincteroplasty in obese patients.

Methods

Patients with fecal incontinence (FI) who underwent sphincter repair were identified and divided into obese [body mass index (BMI) ≥ 30 kg/m2] and nonobese (BMI < 30 kg/m2) groups. Cleveland Clinic Florida FI Score (CCFFIS: 0 best and 20 worst) and FI quality of life (FIQoL) score (mean global FIQoL: 4.11 best and 1 worst) were recorded. Wilcoxon and Mann–Whitney U tests compared quantitative variables; Fisher’s exact test was used for categorical variables.

Results

Seventy-nine patients (78 females; mean age: 57 ± 15 years) were divided into obese (n = 15) and nonobese (n = 64) groups and were similar in age, etiology, physiologic parameters, and preoperative CCFFIS. Median follow-up was 64 (13–138) months. There were 3 (25 %) and 11 (17 %) complications in the obese and nonobese groups, respectively (p = 0.68), the most common being wound infection. Mean CCFFIS decreased from 16.0 ± 3.9 to 11.5 ± 6.5 in the obese (p < 0.001) and 16.2 ± 3.4 to 8.4 ± 5.0 in the nonobese groups (p < 0.001). Postoperative CCFFIS correlated with FIQoL (Spearman’s correlation coefficient = −0.738, p < 0.001). Nonobese patients had significantly higher CCFFIS improvement (48 vs. 28 % p = 0.04) and a superior mean global FIQoL score (2.19 ± 0.9 vs. 2.93 ± 0.8, p < 0.01). Four (29 %) obese and 11 (17 %) nonobese patients required further surgery after failed sphincteroplasty (p = 0.45).

Conclusions

Risk of complications and need of further continence surgery were similar between obese and nonobese patients. However, obese patients experienced less improvement after sphincteroplasty.
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Metadata
Title
Suboptimal results after sphincteroplasty: another hazard of obesity
Authors
K. D. Hong
G. DaSilva
J. T. Dollerschell
S. D. Wexner
Publication date
01-11-2014
Publisher
Springer Milan
Published in
Techniques in Coloproctology / Issue 11/2014
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-014-1195-z

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