Influence of sphincter defect on biofeedback outcomes in patients with fecal incontinence

Autor:	Giovanna da Silva, Roberto Kaiser, Domingo Marcolino Braile, Steven D. Wexner
Rok vydání:	2014
Předmět:	medicine.medical_specialty medicine.medical_treatment Ultrasson endoanal Urology Biofeedback RC799-869 Electromyography Endoanal ultrasound 03 medical and health sciences 0302 clinical medicine Fecal incontinence Medicine Anorectal physiology In patient 030212 general & internal medicine Defeito esfincteriano medicine.diagnostic_test business.industry Gastroenterology Diseases of the digestive system. Gastroenterology Anal canal Surgery medicine.anatomical_structure Sphincter Sphincter defect 030211 gastroenterology & hepatology medicine.symptom business Incontinência fecal
Zdroj:	Journal of Coloproctology (Rio de Janeiro), Volume: 34, Issue: 2, Pages: 67-72, Published: APR 2014 Journal of Coloproctology, Vol 34, Iss 2, Pp 67-72 (2014) Journal of Coloproctology (Rio de Janeiro) v.34 n.2 2014 Journal of Coloproctology (Rio de Janeiro. Online) Sociedade Brasileira de Coloproctologia (SBCP) instacron:SBCP
ISSN:	2317-6423 2237-9363
DOI:	10.1016/j.jcol.2014.04.004
Popis:	Objective: to evaluate the effect of sphincter defect (SD) on biofeedback (BF) response in patients with fecal incontinence. Methods: two hundred and forty-two patients with fecal incontinence undergoing BF as exclusive treatment were identified from a BF database. Patients were evaluated with fecal incontinence score (Cleveland Clinic Florida – Fecal Incontinence Score, CCF-FI) and anorectal physiology tests. The pre- and immediate post-treatment outcomes were obtained from the chart, and the long-term outcomes by CCF-FI score that was sent by mail. Results: 242 patients underwent BF for fecal incontinence. 143 (59.1%) underwent ultrasonography, 43 (30.1%) of whom had sphincter defect detected on US. The immediate outcomes were not affected by the presence of absence of SD. The second CCF-FI questionnaire was mailed after a mean of 6.1 years after treatment. 31 (57.4%) exhibited improvement, 4 (7.4%) remained unchanged, and 19 (35.2%) had worsening function, which was significantly inferior in patients with SD (p = 0.021). Electromyography demonstrated increased electrical activity in the contraction phase after BF in both groups. Conclusions: the majority of patients experience improvement in fecal incontinence after BF. However, patients with SD detected on US prior to treatment seem to have worse function at long term. Resumo: Objetivos: avaliar a influência do defeito esfincteriano (DE) na resposta ao biofeedback (BF) em pacientes com incontinência fecal. Métodos: 242 pacientes com incontinência fecal, submetidos exclusivamente ao BF como forma de tratamento, foram selecionados. Os pacientes foram submetidos ao escore de incontinência fecal (Cleveland Clinic Flórida-Escore de Incontinência Fecal, CCF-IF) e testes de investigação da fisiologia anorretal. O pré e pós-tratamento imediato foram obtidos do prontuário e para avaliação a longo prazo foi enviado o CCF-IF pelo correio. Resultados: 242 pacientes realizaram BF. 143 (59,1%) realizaram ultrassom e em 43 (30,1%) foi evidenciado DE. Os resultados imediatamente após o BF não foram afetados pela presença ou ausência de DE. O segundo questionário foi enviado pelo correio com tempo médio de 6,1 anos após término do BF. 31 (57,4%) melhoraram, 4 (7,4%) permaneceram inalterados e 19 (35,2%) pioraram, mas nos pacientes com DE a melhora foi significativamente inferior (p = 0,021). A eletromiografia demonstrou melhora na atividade elétrica na fase de contração em ambos os grupos. Conclusões: houve melhora clínica na maioria dos pacientes com incontinência fecal após o BF. Entretanto, pacientes com DE detectados ao US antes do tratamento, apresentaram piores resultados a longo prazo. Keywords: Fecal incontinence, Biofeedback, Sphincter defect, Endoanal ultrasound, Palavras-chave: Incontinência fecal, Biofeedback, Defeito esfincteriano, Ultrasson endoanal
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::1241e05f1833442cdadbb7c520d12fb5 https://doi.org/10.1016/j.jcol.2014.04.004 Zobrazit plný text záznamu