Retrospective study over a 10-year period in patients who underwent anal Sphincteroplasty: prognosis and life quality

• Grant number: 18/13595-6
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: February 01, 2019
• End date: January 31, 2020
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Rodrigo Ambar Pinto
• Grantee: Lívia Lemes Prudencio
• Host Institution: Faculdade de Medicina (FM). Universidade de São Paulo (USP). São Paulo , SP, Brazil

Abstract

Anal sphincteroplasty is an important surgical procedure for patients with fecal incontinence. The most common cause is anatomical lesions of the anal sphincter, which do not sufficiently respond to the clinical and minimally invasive management of continence, with biofeedback and sacral electrostimulation. Epidemiologically, this condition is underdiagnosed and has a higher prevalence in the female and older population. Objectives: The purpose of this study was to map the epidemiological profile, comorbidities, and surgical history, as well as to evaluate the results of anal sphincteroplasty thorough analysis of the symptoms of anal incontinence and the quality of life of the patients before and after the procedure. long-term follow-up. Methods: from the survey, systematization, and interpretation of data from medical records of patients with anal incontinence submitted to sphincter reconstruction (sphincteroplasty) in the last 10 years, associated with questionnaire application of symptoms and quality of life. We will retrospectively evaluate 65 patients with anal incontinence diagnosis associated with a compatible clinical picture, submitted to anal sphincteroplasty. The baseline parameters evaluated in the preoperative period will be: sex, ideas, cause of anal incontinence, number of vaginal deliveries in case of the obstetric cause, comorbidities, Cleveland Clinic Florida anal incontinence index (CCF), anal sphincter manometric values and ultrasonography endoanal. In the recent postoperative period, clinical or surgical complications (mainly infectious) will be evaluated. In the late postoperative period (follow-up), the following will be evaluated: recurrence of incontinence symptoms through the CCF anal incontinence index, the time for relapse and the telephone interview to determine the CCF anal incontinence index; the Pelvic Floor Bother Questionnaire (PFBQ), in order to determine associated pelvic floor disorders; and the subjective satisfaction questionnaire, where the patient's satisfaction with the procedure will be evaluated, if the patient would redo the procedure and/or appoint someone. Statistical analysis: the comparisons between the variables will be performed using the Shapiro-Wilk test, Student's t-test, ANOVA, Turkey test, Mann-Whitney test, Kruskal-Wallis test or Dunn test. ROC curves will be analyzed if risk factors are identified. Simple logistic regression and multiple regression analyzes will be performed to identify risk factors for complications.