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Surgical repair of traumatic cloaca: a modified technique
Author(s) -
Zhou X.,
Chen W.,
Lin J.,
Xu J.,
Zheng S.
Publication year - 2019
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.14764
Subject(s) - medicine , cloaca , surgery , general surgery , anatomy
Abstract Aim A modified repair technique for traumatic cloaca caused by obstetric anal sphincter injury was evaluated, and its feasibility and functional outcome were investigated. Methods A retrospective review of 23 consecutively enrolled patients diagnosed with traumatic cloaca who underwent the modified repair technique between September 2010 and August 2018 was performed. Demographic, clinical feature, operative and follow‐up data were recorded. Results The patients diagnosed with traumatic cloaca who underwent surgical repair after obstetric anal sphincter injury had a median time from obstetric injury of 24 (12–35) years. The median preoperative Wexner faecal incontinence score was 16 (14–17). The postoperative hospital stay was 6 (6–7) days. The median postoperative Wexner faecal incontinence score decreased to 2 (2–3). The anal resting pressure increased from 9.00 (5.25–11.50) mmHg to 56.00 (55.00–65.75) mmHg ( P < 0.01) and the anal squeeze pressure increased from 29.00 (22.50–33.20) mmHg to 110.00 (96.20–121.50) mmHg ( P < 0.01) at 2 months after the repair. Sixteen patients completed the Faecal Incontinence Quality of Life Scale questionnaire, and there were significant improvements 1 year after surgical repair in lifestyle (3.10 [2.60–3.70] vs 2.60 [1.90–3.00], P < 0.01), coping/behaviour (3.38 [2.57–3.44] vs 2.33 [1.89–3.00], P < 0.01), depression/self‐perception (3.11 [2.27–3.44] vs 2.33 [1.89–3.00], P < 0.01) and embarrassment (3.33 [2.75–3.67] vs 2.33 [2.33–3.00], P < 0.01). No patient presented rectovaginal fistula postoperatively within the median follow‐up period of 24 (12–48) months. Conclusions The modified repair technique for traumatic cloaca is feasible and achieves good functional outcomes and improved life quality.