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Anatomical sphincteroplasty as a surgical treatment for faecal incontinence: proposal for a global anatomical reconstructive surgical procedure and results from a case series

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Abstract

The aim of this study is to describe the technical details and clinical and functional results of anatomical sphincteroplasty as a global reconstructive surgery for the treatment of faecal incontinence caused by anal sphincter lesions. This was a prospective, longitudinal study that included patients who underwent the anatomical sphincteroplasty procedure described here to treat complete sphincter damage. We have described the different technical steps in detail. We evaluated the intraoperative and postoperative complications rate, Cleveland Clinic Score (CCS), a modification of the CCS that included soiling (mCCS), the Faecal Incontinence Quality of Life Scale (FIQLS), and patient satisfaction. An endoanal ultrasound and anorectal manometric study were performed in all the patients. Forty-four patients were included with a mean of 40.5 months follow-up. The CCS reduced from 15 to 3.3 points and the mCCS from 18.5 to 4.5 points over the study period; p < 0.001. Excellent or good results were achieved in 93% of cases. Endoanal ultrasounds showed a good sphincter repair in 66% of the cases. Anorectal manometry showed an increase in the mean maximal resting pressure from 27.6 mmHg to 41.7 mmHg and of the maximal squeeze pressure from 57.9 to 93 mmHg (p < 0.001) with respect to the preoperative values. Anatomical sphincteroplasty is a surgical proposal for the global anatomical reconstruction of anal sphincter lesions, even in cases of very severe damage. The procedure is safe and produced excellent clinical and functional results after a medium-term follow-up.

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Data availability

All data, analytic methods, and study materials used to conduct the research will be made available to any researcher by the corresponding author (J.G.A.), upon reasonable request.

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Authors and Affiliations

  1. European Centre of Colorectal SurgeryColoproctology Unit, Hospital Vithas Valencia 9 de Octubre, Valencia, Spain

    Juan García-Armengol, José V. Roig-Vila, María García-Gausí, Vicente Pla-Martí & David Moro-Valdezate

  2. Colorectal Surgery Unit, Consorcio Hospital General Universitario de Valencia, Valencia, Spain

    Carolina Martínez-Pérez & María J. García-Coret

  3. Colorectal Surgery Unit, Hospital Punta de Europa, Algeciras, Spain

    María García-Gausí

  4. Colorectal Surgery Unit, Hospital Clínico Universitario de Valencia, Valencia, Spain

    Vicente Pla-Martí & David Moro-Valdezate

Authors
  1. Juan García-Armengol
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  2. Carolina Martínez-Pérez
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  3. José V. Roig-Vila
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  4. María García-Gausí
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  6. María J. García-Coret
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  7. David Moro-Valdezate
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Correspondence to Juan García-Armengol.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

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The study protocol was approved by the local ethics committee (Consorcio hospital general universitario valencia).

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García-Armengol, J., Martínez-Pérez, C., Roig-Vila, J.V. et al. Anatomical sphincteroplasty as a surgical treatment for faecal incontinence: proposal for a global anatomical reconstructive surgical procedure and results from a case series. Updates Surg (2024). https://doi.org/10.1007/s13304-023-01749-4

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