A UK wide survey of general surgeons' experience of the primary repair of obstetric anal sphincter injuries.

Autor: Elsaid N; St Mark's the National Bowel Hospital, London, UK.; Imperial College London, London, UK., Thomas GP; St Mark's the National Bowel Hospital, London, UK.; Imperial College London, London, UK., Carrington EV; Imperial College London, London, UK.; Imperial College Healthcare NHS Trust, London, UK., Fernando RJ; Imperial College London, London, UK.; Imperial College Healthcare NHS Trust, London, UK., Vaizey CJ; St Mark's the National Bowel Hospital, London, UK.; Imperial College London, London, UK.
Jazyk: angličtina
Zdroj: Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland [Colorectal Dis] 2024 Nov 20. Date of Electronic Publication: 2024 Nov 20.
DOI: 10.1111/codi.17244
Abstrakt: Aim: Obstetric anal sphincter injuries (OASIs) are associated with devastating consequences, mainly faecal incontinence. A timely and correct repair is necessary to reduce the risk of maternal morbidity. The aim was to explore the experience and practice of on-call general surgeons in the acute repair of OASIs.
Method: A cross-sectional, observational questionnaire study was performed. Registrars and consultants participating in an emergency general surgical rota in the UK were included. A 33-item questionnaire was disseminated over a 9-month period from April 2023. A descriptive, thematic analysis of the data was undertaken.
Results: In all, 310 responses were analysed. 42.3% of colorectal respondents (of which 29% were pelvic floor specialists), 24.3% of general surgeons, 16.7% of hepato-biliary surgeons and 13.7% of upper gastrointestinal surgeons were contacted to assist with an acute repair. Of those contacted, 52.3% typically assisted with a 3C or 4 tear, 54.2% received no training and 95.5% performed less than three acute repairs in the previous year. 57.6% of all respondents were not confident at all in the repair of these injuries, 55% highlighted a lack of experience and 36% mentioned a curricular gap.
Conclusion: Surgeons may be called to assist with an acute OASI repair, particularly in cases of severe anatomical disruption. This occurs infrequently. There is a lack of consensus as to who is responsible for these injuries. Obstetricians have structured training in both the recognition and repair of these injuries. This paper serves to highlight the lack of training for surgeons who report doing this surgery despite lacking the required competences.
(© 2024 The Author(s). Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.)
Databáze: MEDLINE
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