0000000000416509
AUTHOR
Vicente Pla Martí
Evolución de la continencia y de la calidad de vida tras esfinteroplastia por incontinencia fecal de origen obstétrico
La incontinencia fecal es un síntoma de gran trascendencia social que puede incapacitar a la persona que la padece. El traumatismo obstétrico es la causa más frecuente en pacientes atendidas en una unidad de coloproctología. El 13% de las mujeres desarrollan algún grado de incontinencia o urgencia tras su primer parto vaginal. En las pacientes con lesión esfinteriana asociada a incontinencia fecal grave subsidiarias de tratamiento quirúrgico, la técnica de elección es la esfinteroplastia anterior del esfínter anal externo, descrita originalmente por Parks y Mc Partlin. Los resultados publicados a corto plazo son buenos en la mayoría de las series pero en aquellas con seguimientos mayores se…
Sphincter damage during fistulotomy for perianal fistulae and its relationship with faecal incontinence.
Abstract Background The length of sphincter which can be divided during fistulotomy for perianal fistula is unclear. The aim was to quantify sphincter damage during fistulotomy and determine the relationship between such damage with symptoms and severity of faecal incontinence and long-term quality of life (QOL). Methods A prospective cohort study was performed over a 2-year period. Patients with intersphincteric and mid to low transsphincteric perianal fistulas without risk factors for faecal incontinence were scheduled for fistulotomy. All patients underwent 3D endoanal ultrasound (3D-EAUS) pre-operatively and 8 weeks postoperatively. Measurements were taken of pre- and postoperative anal…
Concordance and survival implications of preoperative subclassification of T3 rectal cancers by depth of mesorectal invasion using a 5-mm cut-off point with endorectal ultrasound and magnetic resonance imaging.
BACKGROUND: Validated rectal cancer staging groups T3 tumours in a single stage and depth of mesorectal invasion subclassification is not standard practice. Our aim is to report concordance between magnetic resonance imaging (MRI) and endorectal ultrasound (ERUS) for preoperative staging of T3 rectal tumours using a 5-mm cut-off point and possible survival implications. METHODS: Prospective cohort study including patients staged preoperatively as cT3 by ERUS or magnetic resonance imaging. The maximum depth of penetration beyond the outer longitudinal muscle layer was measured according to a 5-mm cut-off point. Concordance rate and Kappa coefficient were calculated for both techniques. Prima…