Surgical Treatment Of Old Perineal Laceration With Anal Incontinence

Objective: To explore the clinical effect of overlapping anastomosis on old perineal lacerations and anal incontinence.Methods: Analyze the operation time,hospitalization time,intraoperative bleeding volume,and incision healing time of 106 cases of old perineal third degree laceration combined with anal incontinence who attended the Department of Anorectal Surgery of Xinjiang Medical University from 2008 to 2018.Comparative analysis before and after surgery in patients with subjective perineum exterior satisfaction,perineal discomfort,the bowel movement control situation,patients with postoperative and preoperative rectal pressure,anal ultrasound examination of the recent curative effect and postoperative regularly followed up for 1 month,3 months,6 months,12 months of anal incontinence scores,painful intercourse,anal stenosis,whether relapse of long-term outcome.Results: The operation time was(66.70 ± 17.78)min,the hospital stay was(12.15 ± 1.46)days,the intraoperative blood loss was(53.54 ± 9.54)ml,and the incision healing time was(13.14 ± 1.68)days.Appearance satisfaction(8.44 ± 1.12)points,the subjective feeling of perineal discomfort disappeared after surgery;104 patients complained that defecation can be controlled,2 cases can control defecation,but not control the gas;There were statistically significant differences in rectal resting pressure,anal resting pressure,anal maximal systolic pressure,anal autonomic contraction time after surgery and preoperative rectal resting pressure,anal resting pressure,anal maximal systolic pressure,and anal autonomic contraction time(P < 0.05);The score of anal incontinence at 3,6 and 12 months after operation was statistically significant from that before operation.Postoperative anal ultrasound examination of the sphincter were continuous;Regular follow-up was conducted for 3 months after surgery,and there was no statistically significant difference between preoperative and postoperative pain of sexual intercourse(P>0.05),while there was a statistically significant difference between preoperative and postoperative pain of sexual intercourse at 6 months and 12 months(P < 0.05).No anal stenosis or long-term recurrence was found after surgery.Conclusion: The correct surgical method can cure old perineal lacerations.It is important to determine the anal sphincter anatomy and the importance of postoperative management,which can effectively improve the anal incontinence and improve the quality of life of patients.