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Criado em : 02 Aug 2014
Alterado em : 02 Aug 2014

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Nota bibliográfica (sem autor) :

Overlapping compared with end-to-end repair of complete third-degree or fourth-degree obstetric tears: three-year follow-up of a randomized controlled trial - Obstetrics and Gynecology - Vol. 120, 4 - ISBN: 1873-233X - p.803-808

Autores :

Farrell, Scott A.; Flowerdew, Gordon; Gilmour, Donna; Turnbull, Geoffrey K.; Schmidt, Matthias H.; Baskett, Thomas F.; Fanning, Cora A.

Ano de publicação :

2012

URL(s) :

https://doi.org/10.1097/AOG.0b013e31826ac4bb

Résumé (français)  :

Abstract (English)  :

OBJECTIVE: To report on a 3-year follow-up of women who underwent overlapping repair of a complete third-degree or fourth-degree obstetric tear.
METHODS: Primiparous women sustaining a complete third-degree or a fourth-degree tear of the perineum were randomized to a primary sphincter repair using either an end-to-end or an overlapping surgical technique. At 1, 2, and 3 years, questionnaires on rates of flatal and fecal incontinence were mailed to participants.
RESULTS: At 1 year, women who underwent an end-to-end repair reported lower rates of flatal and fecal incontinence than women who had an overlapping repair. For flatal incontinence the rates were 31% compared with 56% (95% confidence interval for the rate difference 6-43%, P=.012). For fecal incontinence, the rates were 7% compared with 16% (95% confidence interval for the rate difference -4% to 21%, P=.17). The difference between the two methods of surgical repair had largely disappeared by the end of year 2.
CONCLUSION: At 1-year follow-up, end-to-end repair of complete third-degree or fourth-degree obstetric anal sphincter tears is associated with significantly lower rates of anal incontinence when compared with overlapping repair. There is no long-term benefit associated with either technique over the other.
CLINICAL TRIAL REGISTRATION: ISRCTN Register, http://isrctn.org, ISRCTNO 4149919.
LEVEL OF EVIDENCE: I.

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➡ episiotomia

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Import 02/08/2014 — 02 Aug 2014