Functional outcome of total anorectal reconstruction: incontinence or constipation?
Violi, V.; Boselli, A.Stefano.; De Bernardinis, M.; Costi, R.; Sarli, L.; Iusco, D.; Roncoroni, L.
Acta Bio-Medica Atenei Parmensis 74(Suppl 2): 103-107
2003
ISSN/ISBN: 0392-4203 PMID: 15055046 Document Number: 552205
Besides incontinence, constipation is important after TAR. We aimed at evaluating their correlation and role in functional outcome. 81 diaries in 16 patients (up to 8 years) were assessed, by a specific scoring system, regarding incontinence and evacuation. In the overall series and in three postoperative time groups, the correlation between the two items, their mean scores and relative score rates (% of the maximum possible scoring) were calculated. The Spearman correlation coefficient in all assessments was -0.128. According to timing, it was: 0.468 (short term), -0.036 (mean term) and -0.69 (long term). Incontinence was more disabling than evacuation; constipation occurred more frequently. Incontinence improved over time; constipation did not substantially change. Current criteria for functional assessment do not describe the true conditions after TAR and their variations over time. Profound consideration is necessary before announcing ultimate judgements on TAR.