Suboptimal results after sphincteroplasty

another hazard of obesity

Kwang Dae Hong, G. DaSilva, J. T. Dollerschell, S. D. Wexner

Research output: Contribution to journalArticle

Abstract

Background: This study aimed to investigate the outcomes of sphincteroplasty in obese patients.

Methods: Patients with fecal incontinence (FI) who underwent sphincter repair were identified and divided into obese [body mass index (BMI) ≥ 30 kg/m2] and nonobese (BMI < 30 kg/m2) groups. Cleveland Clinic Florida FI Score (CCFFIS: 0 best and 20 worst) and FI quality of life (FIQoL) score (mean global FIQoL: 4.11 best and 1 worst) were recorded. Wilcoxon and Mann–Whitney U tests compared quantitative variables; Fisher’s exact test was used for categorical variables.

Results: Seventy-nine patients (78 females; mean age: 57 ± 15 years) were divided into obese (n = 15) and nonobese (n = 64) groups and were similar in age, etiology, physiologic parameters, and preoperative CCFFIS. Median follow-up was 64 (13–138) months. There were 3 (25 %) and 11 (17 %) complications in the obese and nonobese groups, respectively (p = 0.68), the most common being wound infection. Mean CCFFIS decreased from 16.0 ± 3.9 to 11.5 ± 6.5 in the obese (p < 0.001) and 16.2 ± 3.4 to 8.4 ± 5.0 in the nonobese groups (p < 0.001). Postoperative CCFFIS correlated with FIQoL (Spearman’s correlation coefficient = −0.738, p < 0.001). Nonobese patients had significantly higher CCFFIS improvement (48 vs. 28 % p = 0.04) and a superior mean global FIQoL score (2.19 ± 0.9 vs. 2.93 ± 0.8, p < 0.01). Four (29 %) obese and 11 (17 %) nonobese patients required further surgery after failed sphincteroplasty (p = 0.45).

Conclusions: Risk of complications and need of further continence surgery were similar between obese and nonobese patients. However, obese patients experienced less improvement after sphincteroplasty.

Original languageEnglish
Pages (from-to)1055-1059
Number of pages5
JournalTechniques in Coloproctology
Volume18
Issue number11
DOIs
Publication statusPublished - 2014 Jan 1
Externally publishedYes

Fingerprint

Obesity
Fecal Incontinence
Quality of Life
Body Mass Index
Wound Infection

Keywords

  • Fecal incontinence
  • Obesity
  • Sphincteroplasty

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Suboptimal results after sphincteroplasty : another hazard of obesity. / Hong, Kwang Dae; DaSilva, G.; Dollerschell, J. T.; Wexner, S. D.

In: Techniques in Coloproctology, Vol. 18, No. 11, 01.01.2014, p. 1055-1059.

Research output: Contribution to journalArticle

Hong, Kwang Dae ; DaSilva, G. ; Dollerschell, J. T. ; Wexner, S. D. / Suboptimal results after sphincteroplasty : another hazard of obesity. In: Techniques in Coloproctology. 2014 ; Vol. 18, No. 11. pp. 1055-1059.
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abstract = "Background: This study aimed to investigate the outcomes of sphincteroplasty in obese patients.Methods: Patients with fecal incontinence (FI) who underwent sphincter repair were identified and divided into obese [body mass index (BMI) ≥ 30 kg/m2] and nonobese (BMI < 30 kg/m2) groups. Cleveland Clinic Florida FI Score (CCFFIS: 0 best and 20 worst) and FI quality of life (FIQoL) score (mean global FIQoL: 4.11 best and 1 worst) were recorded. Wilcoxon and Mann–Whitney U tests compared quantitative variables; Fisher’s exact test was used for categorical variables.Results: Seventy-nine patients (78 females; mean age: 57 ± 15 years) were divided into obese (n = 15) and nonobese (n = 64) groups and were similar in age, etiology, physiologic parameters, and preoperative CCFFIS. Median follow-up was 64 (13–138) months. There were 3 (25 {\%}) and 11 (17 {\%}) complications in the obese and nonobese groups, respectively (p = 0.68), the most common being wound infection. Mean CCFFIS decreased from 16.0 ± 3.9 to 11.5 ± 6.5 in the obese (p < 0.001) and 16.2 ± 3.4 to 8.4 ± 5.0 in the nonobese groups (p < 0.001). Postoperative CCFFIS correlated with FIQoL (Spearman’s correlation coefficient = −0.738, p < 0.001). Nonobese patients had significantly higher CCFFIS improvement (48 vs. 28 {\%} p = 0.04) and a superior mean global FIQoL score (2.19 ± 0.9 vs. 2.93 ± 0.8, p < 0.01). Four (29 {\%}) obese and 11 (17 {\%}) nonobese patients required further surgery after failed sphincteroplasty (p = 0.45).Conclusions: Risk of complications and need of further continence surgery were similar between obese and nonobese patients. However, obese patients experienced less improvement after sphincteroplasty.",
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