Summary Results Table 1Sphincter Repair

StudySurgery typeFollow-up (months)NN. at follow-upFaecal Incontinence:ComplicationsComments
CuredimprovedNot improvedWound infection?Bleeding?Unknown or other?
CRPRCRPRCRPR
Engel1994b113Anterior sphincter repair (wrap-over)15555545%031%24%External sphincter defect
Giordano2002146Anterior overlapping sphincter repair20151External sphincter defect.
Poorer results in patients with repeat repairs (not significant)
Oliveria1996293Anterior overlapping sphincter repair29555571%29%2%4%Anterior defects
Morren1997261Direct and overlapping sphincter repair.40675535%65%11%2%11%External sphincter defect. Surgery combined with an anterior levator plasty (n=45), internal sphincter placation (n=24) and postanal repair (n=1)
Young1998441Overlapping sphincter repair27565686%14%2%38%Anterior and laterally placed single anal sphincter defects
Karoui2000194Overlapping sphincter repair40867418%58%24%External and associated internal sphincter defect
Fleshman 1991a130Overlapping sphincter repair24555550%22%28%15%2%Rectovaginal fistula (n=15) also repaired during surgery. 22% of cured are incontinent to gas
Londonos chimmer1994221Overlapping sphincteroplasty591289414%36%50%16%2%8%External sphincter defect. In addition to repair: plication (n=7), repair of rectovaginal fistula (n=4), posterior vaginal repair (n=2) and miscellaneous (n=3).
Zorcolo2005444Anterior anal sphincter repair70937382%17%1%25%Internal and external sphincter defects. Repair reinforced with levatoplasty (n=51) and had better outcomes than group without levatorplasty (not significant)
Gutierrez et al152Overlapping sphincteroplasty1201911306%16%76%16% of cured patients incontinent to gas.
Sphincter defect.
Arnaud199115Direct sphincter repair17404063%15%22%13%
Bartolo199024Anterior sphincter repair60303067%Additional levatorplasty or posterior colporrhaphy was performed
Elton2002111Overlapping anterior sphincter repair13202080%20%10%5%
Engel1994a115Overlapping sphincter repair46282858%21%21%4%4%Additional levatorplasty (n=16)
Gibbs1993143Overlapping sphincter repair43363388%12%6%25%
Gilliland1998145Overlapping sphincter repair241057755%45%4%14%Levatorplasty performed in 58 of the patients
Malouf2000c231Overlapping sphincter repair77553650%50%
Osterberg 2000299Overlapping sphincter repair122020
Rothbarth 2000351Overlapping sphincter repair39393962%38%7%5%Combined with puborectal muscle plasty (n=32) and additional posterior vaginal wall repair (n=5)
Simmang 1994377Overlapping sphincter repair12141493%7%
Ternent1997397Anterior overlapping sphincteroplasty12353562%38%
Briel199838Direct sphincter repair and overlapping with internal imbrication24555565%35%11%9%
Fleshman 1191129Overlapping13282875%25%7%7%
Chen199858Sphincter repair by plication method50151595%5%13%
Engel1997114Overlapping repair12202030%5%
Briel199939Anterior anal sphincter repair12202065%35%
Sangwan 1996357Overlapping sphincter repair161515404713
Jensen1997187Biofeedback after sphincteroplasty32282889%10%0%0%0%
Steele2006385overlapping anal sphincteroplasty33.8282843%
Weighted mean (95% CI)40% (15–65)27% (23–31)47% (22–72)52% (49–55)13% (4–30)36% (33–39)10% (8–12)3% (1–5)12% (9–14)

Key:

CR – clinician reported

PR – patient reported

From: APPENDIX E, SUMMARY RESULTS TABLES FOR SURGICAL CASE SERIES

Cover of Faecal Incontinence
Faecal Incontinence: The Management of Faecal Incontinence in Adults.
NICE Clinical Guidelines, No. 49.
National Collaborating Centre for Acute Care (UK).
Copyright © 2007, National Collaborating Centre for Acute Care.

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