Roper Joanna C, Thakar Ranee, Sultan Abdul H
Department of Obstetrics and Gynaecology, Croydon University Hospital, Croydon, UK.
St George's University of London, London, UK.
Colorectal Dis. 2024 Jan;26(1):130-136. doi: 10.1111/codi.16820. Epub 2023 Dec 26.
The role of colorectal surgeons in the management of acute obstetric anal sphincter injury (OASI) is an ongoing debate. Their expertise in operating in the anorectal region lends itself to assisting in OASI repair. The aim of this study was to establish the current involvement and recommended management of acute OASI by colorectal surgeons.
An online survey of consultant colorectal surgeons was sent to members of the Pelvic Floor Society to assess current involvement in acute OASI management and repair.
Forty completed surveys were collated and analysed. Sixty-five per cent of respondents had seen an acute OASI since being a consultant and 50% stated they were involved in the repair of OASI less than once per year. 37.5% felt that a de-functioning stoma was still necessary sometimes. Many agreed with current guidelines for OASI repair in terms of antibiotics, laxatives and follow-up.
Colorectal surgeons have varied opinions on the management of OASI. We suggest that multidisciplinary training of obstetricians and colorectal surgeons could lead to more collaboration regarding the management of women with acute OASI.
结直肠外科医生在急性产科肛门括约肌损伤(OASI)管理中的作用一直存在争议。他们在肛肠区域的手术专业知识有助于协助进行OASI修复。本研究的目的是确定结直肠外科医生目前在急性OASI管理中的参与情况及推荐的处理方法。
向盆底协会成员发送了一份针对结直肠外科顾问医生的在线调查问卷,以评估他们目前在急性OASI管理和修复中的参与情况。
整理并分析了40份完整的调查问卷。65%的受访者自成为顾问医生以来见过急性OASI病例,50%的受访者表示他们每年参与OASI修复的次数少于一次。37.5%的人认为有时仍需要做造口去功能化。许多人在抗生素、泻药和随访方面认同目前OASI修复的指南。
结直肠外科医生对OASI的管理有不同的看法。我们建议产科医生和结直肠外科医生进行多学科培训,这可能会使双方在急性OASI女性患者的管理上有更多合作。