Long-term Follow-up After Surgery for XXXX : Fecal Incontinence and Impact on Quality of Life.

@entity1 @entity308 @entity322 @entity292 @entity954 @entity1241
BACKGROUND: Surgical management of cryptoglandular fistulas is a challenge because the consequences of anal surgery potentially include @entity1241 and impaired quality of life. OBJECTIVE: To assess factors associated with @entity1241 after surgery for simple and @entity292 and to determine the impact of @entity322 on quality of life. DESIGN: The design is retrospective and cross-sectional. SETTINGS: This study was conducted at an academic tertiary center and at a private center specializing in proctologic surgery. @entity1 : All @entity1 who underwent preoperative endoanal ultrasound for cryptoglandular @entity292 between 2002 and 2012. MAIN OUTCOME MEASURES: A questionnaire was sent out in October 2013 to evaluate @entity322 (Wexner-score) and its impact on quality of life (FIQL). Variables tested for association were @entity1 demographics, @entity292 type, number of incised abscesses (0, 1, >1), number of fistulotomies (0, 1, >1) and number of sphincter-sparing procedures (0, 1, >1). RESULTS: Of the 141 @entity1 participating, 116 (82%; 76 @entity1 , 40 @entity1 ) returned all the questionnaires. Median follow-up from the first perianal @entity292 surgery was 7.8 years (range, 2.1-18.1 years). Thirty-nine @entity1 (34%) experienced @entity322 . @entity954 , multiple abscess drainages and a high transsphincteric or suprasphincteric @entity292 tract were associated with @entity322 . As compared to simple @entity292 (Wexner score, 1.2 [SD, 2.1]), @entity322 was worse after surgery for complex @entity292 (Wexner score, 4.7 [SD, 6.2], p = 0.001), as were quality of life elements, including lifestyle (p = 0.030), @entity308 (p = 0.077) and embarrassment (p < 0.001). LIMITATIONS: Mainly retrospective design without a standardized treatment protocol. CONCLUSION: @entity954 is the strongest risk factor for @entity1241 . The severity of @entity322 increases with the complexity of the @entity292 , negatively influencing quality of life. Special attention should be paid to these @entity1 so as to mitigate symptoms later in life. A shift to sphincter-sparing procedures appears warranted.
