SPHINCTEROPLASTY IN THE TREATMENT OF ANAL INCONTINENCE ON THE BASIS OF NECROTIZING FASCIITIS

• Main Authors: O. E. Kanikovskyi, A. V. Osadchyi, O. A. Kotsyura, A. V. Tomashevskyi, T. P. Zarezenko
• Format: Article
• Language: English
• Published: State Institution of Science «Research and Practical Center of Preventive and Clinical Medicine» State Administrative Department 2019-10-01
• Series: Клінічна та профілактична медицина
• Subjects: sphincteroplasty, necrotic fasciitis, anal incontinence
• Online Access: http://cp-medical.com/index.php/journal/article/view/86

Incontinence of intestinal contents is a serious disease that gives patients strong emotional and psychological feelings leading to social self-isolation, unsuitability and disability of the population. From an analysis of scientific research, it is known that more than 30% of coloproctologic operations are complicated by insufficiency of the sphincter apparatus and lead to anal incontinence. The purpose of the study - to improve the results of treatment for anal incontinence. Material and methods. 44 patients with perineal NF were analyzed. Patients were treated in the surgical clinic of the Faculty of Medicine No. 2 of VNMU and Vinnitsa City Clinical Hospital of Emergency Medical Services from 2010 to 2018. The average age is 59.0±8.72 years (26-80). There are 11 women and 33 men. Age <20 - 0, 21-29 – 1 (2.27%), 30-39 – 2 (4.54%), 40-49 – 7 (15.9%), 50-59 – 10 (22.74%), >60 years old – 24 (54.5%). Results and their discussion. The development of postoperative anal incontinence was identified in 13 (29,5%) patients. An anal incontinence scale (Wexner) was used to verify the diagnosis of anal canal failure. The surgical treatment technique was performed both in patiently in 4 (9.0%) patients and on an outpatient basis in 4 (9.0%). With cicatricial changes in the anal canal, the rumen was excised, the sphincter edges were mobilized, allograft implantation and sphincteroplasty were performed. Narrowing the anal canal is a less traumatic method that can be performed on an outpatient basis and in hospitals of one day. After surgery, patients independently retain gases and feces. Conclusions. Patients with NF requiring immediate surgical treatment. Anal incontinence on the basis of the transferred NF leads to disability. The narrowing of the anal canal using a mesh transplant is minimally invasive, characterized by a mild postoperative course.Sphincteroplasty is possible to carry out stationary and on an outpatient basis under local anesthesia. Restoration of the function of the sphincter apparatus in 100% of the operated patients on the Wexner scale, which improves the level of physical and social life of patients.