Overlapping anal sphincter repair and anterior levatorplasty: effect of patient's age and duration of follow-up.
OBJECTIVE
Anal sphincter repair can improve function in patients with faecal incontinence but it is unclear which benefit and its long-term efficacy has been questioned. This study aims to assess the functional outcome of a single surgeon series of overlapping anal sphincter repairs with anterior levatorplasty.


METHODS
A retrospective study of 66 patients' case notes and anorectal physiology combined with an interview to assess their current continence and associated quality of life after surgery.


RESULTS
Sixty-six female patients, mean age 62.8 years, mean follow-up 45.2 months, were assessed. Functional improvement in continence was seen in 77.1% of patients, which mirrored their subjective rating of surgery (62.7%--good/excellent). Continence grading scores improved from a mean (SD) 9.71 (4.82) pre-surgery to 5.55 (4.11) post-surgery. There was no statistical difference in functional results when stratified by age (<63 years or > or =63 years) or by follow-up [long-term (43-78 months) vs short-term (14-42 months)]. Post-surgical physiology data were not statistically improved compared to pre-surgery.


CONCLUSIONS
Overlapping anal sphincter repair with anterior levatorplasty is an effective treatment for faecal incontinence. Patient age does not correlate with outcome, and symptoms do not deteriorate over time. Anorectal physiology results don't predict for symptomatic improvement in patients with faecal incontinence.
Evans
Charles
C
Colorectal Surgery Unit, St James Wing (Level III), St George's Hospital, Blackshaw Road, London, SW17 0QT, UK.
Davis
Kathy
K
Kumar
Devinder
D
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013505:Digestive System Surgical Procedures; D005242:Fecal Incontinence / Q000503:physiopathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008131:London; D008365:Manometry; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D012007:Rectum / Q000503:physiopathology; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional