ArticleIndian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India
Management of fourth degree obstetric perineal tear without colostomy using non - stimulated gracilis - our experience over eleven years.
Article in Indian journal of plastic surgery : official publication of the Association of Plastic Surgeons of India. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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- Outcomes of graciloplasty in the treatment of fecal incontinence: a systematic review and meta-analysis of the literature.Techniques in coloproctology · 2023Pooled it
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4 authors at 1 institution in 1 country.
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Abstract
backgroundAlthough gracilis muscle transposition for faecal incontinence has been well-described method, its literature for use in obstetric perineal tear without colostomy is sparse. In this study, we have tried to analyse its use in fourth-degree obstetric perineal tears. PATIENTS AND
methodsA total of 30 patients with recto-vaginal fistula with faecal incontinence secondary to obstetric perineal tear were retrospectively studied between February 2003 and May 2014. The recto-vaginal fistula was explored, dissected and identification of sphincters was done using muscle stimulator. Fistula closure was done followed by sphincter repair, vaginal tightening procedure and single gracilis transposition. None of the patients had covering colostomy. Faecal incontinence was assessed pre- and post-operatively by digital rectal examination (single examiner), Park's score and Corman's score in all cases and using barium hold and transperineal ultrasonography, manometric studies in a few cases. The outcome was measured at an average follow-up of 8.8 months (7-24 months).
resultsAs per Park's score 26 patients had Grade I continence, two had Grade II and two patients had Grade III continence. Corman's score improved from fair to excellent in 26 patients. The patients in whom manometry was performed showed a remarkable rise in both resting and squeeze pressures. Two patients developed post-operative infections in upper 1/3 thigh incision site and three patients at gluteal region scar site.
conclusionSatisfactory continence following gracilis muscle could be achieved.
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