Technique and results of the first six cases of anal sphincteroplasty with Deoti's flap for complex anatomical deformity of the perineum

Journal of Coloproctology - Tập 38 - Trang 183-188 - 2018
Beatriz Deoti Silva Rodrigues1, Igor Guedes Nogueira Reis2, Isabelle Reis Daldegan3, Kelly Cristine de Lacerda Rodrigues Buzatti4
1Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Departamento de Cirurgia, Belo Horizonte, MG, Brazil
2Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
3Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil
4Universidade Federal de Minas Gerais (UFMG), Hospital das Clínicas, Belo Horizonte, MG, Brazil

Tóm tắt

Abstract Objectives Anal sphincteroplasty with Deoti's flap is a recently published procedure for the treatment of fecal incontinence with severe perineal deformity. The aim of this study is to report six cases of patients, analyzing their results in fecal incontinence questionnaires and proposing a new scale to better assess our technique's main objective, the reconstruction of the perianal anatomy. Methods Six patients were submitted to anal sphincteroplasty with Deoti's flap and follow-up was performed every six months. Functional results and Quality of Life were measured by Wexner Score and Fecal Incontinence Quality of Life Scale, respectively. Results All operations were carried out without failure to perform Deoti's flap rotation. The sample presented medians of 18.5 and 3.5 on Wexner Score, before and after surgery, respectively. In the Fecal Incontinence Quality of Life Scale, the medians before and after surgery are, respectively, 1.75 and 3.35 (Scale 1), 1.54 and 2.60 (Scale 2), 2.35 and 3.28 (Scale 3), 1.49 and 3.33 (Scale 4). The p-values were 0.0173 for Wexner Score and 0.0260, 0.0411, 0.0368 and 0.0952 for Scales 1, 2, 3 and 4 of Fecal Incontinence Quality of Life Scale, respectively. All patients presented sustained improvement in Wexner Score and in quality of life questionnaire (in all scales of Fecal Incontinence Quality of Life Scale). Conclusions Deoti's surgical flap with sphincteroplasty successfully reconstructs complex anatomical deformities of the perineum. Current questionnaires to assess fecal incontinence may not evaluate properly the anatomical result of the technique, thus we propose a visual scale. In addition, sphincteroplasty with Deoti's flap may have longer-term outcomes in functional results than sphincteroplasty alone.

Tài liệu tham khảo

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Thông tin xuất bản

Journal of Coloproctology

Tập 38

183-188

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