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J Gastrointest Surg. 2009 May;13(5):951-5. doi: 10.1007/s11605-009-0822-x. Epub 2009 Feb 18.

Long-term functional and quality of life outcomes of patients after repair of large perianal skin defects for Paget's and Bowen's disease.

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1
Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL 62704, USA.

Abstract

INTRODUCTION:

The assessment of long- term functional and quality of life outcomes of these patients following repair of large defects after surgical excision has not been reported.

METHODS:

Between 1992 and 2004, at two institutions, 18 patients underwent repair of a perianal defect for Paget's disease (n = 8) or Bowen's disease (n = 10) and were alive with intestinal continuity at last follow-up. Patients were mailed the fecal incontinence quality of life scale (FIQL) and the SF-36.

RESULTS:

Fourteen patients (78%) responded. Median follow-up for responders was 5 years. Mean age was 65 years with 12 females. Subcutaneous skin flaps (11) and split-thickness skin grafts (three) were used to repair the perianal defects, which were circumferential in 11 patients (79%). Nine patients reported incontinence and completed the FIQL. The FIQL scores of patients reporting incontinence were lower for lifestyle, coping/behavior, and embarrassment but not significantly different for depression compared to patients without incontinence. SF-36 scores of the patients were not significantly different from the normative population.

CONCLUSION:

Functional results after repair of large perianal defects are acceptable and overall quality of life (QOL) is similar to the normative population although a large proportion of patients have some form of incontinence that impacts certain aspects of their QOL.

PMID:
19224296
DOI:
10.1007/s11605-009-0822-x
[Indexed for MEDLINE]
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