Anterior anal sphincter repair: results in a district general hospital
Bibliographic record
Abstract
OBJECTIVE: Previous series have evaluated the overlapping anterior anal sphincter repair, but with short-term follow-up and a wide range of results. We assessed our results of the anterior sphincter repair in patients with faecal incontinence. PATIENTS AND METHODS: This was a retrospective study of 20 patients who underwent an anterior anal sphincter repair between October 1994 and July 1999. In 12 of the patients, a polypropylene mesh was inserted in the repair to act as re-inforcement. Pre-operatively, all patients had an anterior anal sphincter defect diagnosed with endo-anal ultrasound. Clinical evaluation included the patient's assessment of improvement and the Cleveland Clinic Continence Score before and after surgery. Manometric studies were performed pre-operatively and a median time of 11.5 mouths postoperatively. RESULTS: At a median follow-up of 13 months (range, 3-61 months), 16 out of 20 (80%) patients said that surgery had improved their symptoms. There was a significant improvement in the continence score from 14 (range, 4-15) before operation to 7 (range, 0-15) after operation (P < 0.01). There were no significant differences in mean anal sphincter length, mean resting and maximum squeeze anal canal pressures before and after surgery. Similar results were obtained in patients with and without mesh re-inforcement. CONCLUSIONS: In our institution, the overlapping anterior anal sphincter repair is successful in relieving symptoms in patients with faecal incontinence due to an anterior sphincter defect. This improvement, however, is not associated with any significant changes in anorectal manometric parameters.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".