Literature DB >> 25005718

Suboptimal results after sphincteroplasty: another hazard of obesity.

K D Hong1, G DaSilva, J T Dollerschell, S D Wexner.   

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/m(2)] and nonobese (BMI < 30 kg/m(2)) 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.

Entities:  

Mesh:

Year:  2014        PMID: 25005718     DOI: 10.1007/s10151-014-1195-z

Source DB:  PubMed          Journal:  Tech Coloproctol        ISSN: 1123-6337            Impact factor:   3.781


  31 in total

1.  Fecal Incontinence Quality of Life Scale: quality of life instrument for patients with fecal incontinence.

Authors:  T H Rockwood; J M Church; J W Fleshman; R L Kane; C Mavrantonis; A G Thorson; S D Wexner; D Bliss; A C Lowry
Journal:  Dis Colon Rectum       Date:  2000-01       Impact factor: 4.585

Review 2.  Etiology and management of fecal incontinence.

Authors:  J M Jorge; S D Wexner
Journal:  Dis Colon Rectum       Date:  1993-01       Impact factor: 4.585

3.  Long-term results of overlapping anterior anal-sphincter repair for obstetric trauma.

Authors:  A J Malouf; C S Norton; A F Engel; R J Nicholls; M A Kamm
Journal:  Lancet       Date:  2000-01-22       Impact factor: 79.321

4.  Clinical and instrumental evaluation of pelvic floor disorders before and after bariatric surgery in obese women.

Authors:  Dajana Cuicchi; Raffaele Lombardi; Stefano Cariani; Luca Leuratti; Ferdinando Lecce; Bruno Cola
Journal:  Surg Obes Relat Dis       Date:  2011-08-28       Impact factor: 4.734

5.  Urinary and anal incontinence in morbidly obese women considering weight loss surgery.

Authors:  Holly E Richter; Kathryn L Burgio; Ronald H Clements; Patricia S Goode; David T Redden; R Edward Varner
Journal:  Obstet Gynecol       Date:  2005-12       Impact factor: 7.661

Review 6.  Obesity and pelvic floor disorders: a systematic review.

Authors:  W Jerod Greer; Holly E Richter; Alfred A Bartolucci; Kathryn L Burgio
Journal:  Obstet Gynecol       Date:  2008-08       Impact factor: 7.661

Review 7.  The effect of obesity on health outcomes.

Authors:  John B Dixon
Journal:  Mol Cell Endocrinol       Date:  2009-07-21       Impact factor: 4.102

8.  Obesity is associated with increased prevalence and severity of pelvic floor disorders in women considering bariatric surgery.

Authors:  Chi Chiung Grace Chen; Patrick Gatmaitan; Sidney Koepp; Matthew D Barber; Bipan Chand; Philip R Schauer; Stacy A Brethauer
Journal:  Surg Obes Relat Dis       Date:  2008-10-29       Impact factor: 4.734

9.  Ten-year outcome after anal sphincter repair for fecal incontinence.

Authors:  Massarat Zutshi; Tracy Hull Tracey; Jane Bast; Amy Halverson; Jeanie Na
Journal:  Dis Colon Rectum       Date:  2009-06       Impact factor: 4.585

10.  Anterior anal sphincter repair in patients with obstetric trauma.

Authors:  A F Engel; M A Kamm; A H Sultan; C I Bartram; R J Nicholls
Journal:  Br J Surg       Date:  1994-08       Impact factor: 6.939

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