Displaced dermal fat flaps for anal sphincter insufficiency

Bagaudinova SG, Kurbanova ZV, Istranov AL, et al. . Displaced dermal fat flaps for anal sphincter insufficiency. Plastic Surgery and Aesthetic Medicine. 2023;(2):32‑41. (In Russ., In Engl.)
https://doi.org/10.17116/plast.hirurgia202302132

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OBJECTIVE

Searching for optimal highly effective surgical approach for anal sphincter insufficiency via anal ring autoplasty.

MATERIAL AND METHODS

The study enrolled 62 patients with anal sphincter insufficiency between 2004 and 2020 at the Russian Railways Hospital (Makhachkala). Inclusion criteria: complaints of intestinal incontinence and objective indicators of reduced pressure in anal canal Patients meeting selection criteria were divided into four groups: group 1 — patients with anal sphincter incontinence after correction of anorectal defects; group 2 — patients with anal sphincter incontinence after proctological surgery; group 3 — anal sphincter incontinence after childbirth; group 4 — patients with idiopathic anal sphincter incontinence. Correction of anal incontinence was performed original technique of displaced perianal dermal fat flaps.

RESULTS

Immediate results were evaluated after 3 weeks, long-term results — after 6 months and 1 year. We assessed the following criteria: patient satisfaction with treatment outcomes, overall improvement in the quality of life, postoperative complications, WIS score (0-20) and degree of anus gaping (complete absence of gaping).

CONCLUSION

Good immediate and long-term treatment outcomes were observed in 87.6% and 46.8% of cases, respectively. Important prognostic criteria are damage to anal sphincter and basal pressure in anal canal. Original correction of anal sphincter incontinence has a long-term effect and requires widespread implementation in clinical practice.

Keywords:

anal sphincter incontinence

autoplasty

dermal fat flaps

Authors:

Bagaudinova S.G.

Dagestan State Medical University

ORCID: 0000-0001-5574-5905

Kurbanova Z.V.

Dagestan State Medical University

ORCID: 0000-0002-2591-9895

Istranov A.L.

Sechenov First Moscow State Medical University

Omarova Kh.Z.

Dagestan State Medical University

ORCID: 0000-0003-1715-3567

Kurbanismailova M.G.

Dagestan State Medical University

ORCID: 0000-0002-6034-4388

Israpilov M.M.

Dagestan State Medical University

ORCID: 0000-0002-3270-3056

Abualrub N.A.

Dagestan State Medical University

ORCID: 0000-0003-1186-5395

Biyachueva L.A.

Sechenov First Moscow State Medical University (Sechenov University);
Pirogov Russian National Research Medical University

ORCID: 0000-0002-4368-9501

Received:

14.12.2022

Accepted:

27.12.2022

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