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Abstract
Aim: of the study: This study aimed to adjust the anal canal resistance in surgical management of incontinence (intraoperatively) through the application of Endo-FLIP and based on the concept of the flow equation to improve the outcome and to correlate subjective and objective parameters of the fecal incontinence to allow prediction of outcomes. Methods: A registry based prospective, consecutive study was performed from January 2015 to January 2017. Forty four incontinent patients treated by different surgical procedures were included. During the procedure the Endo-FLIP was applied to adjust the anal canal dimensions (ACL and ACD) so the ACR could be adjusted based on the flow equation. Anal canal dimensions (length and diameter) and resistance were assessed perioperative with application of EndoFLIP system and the flow equation calculator. The clinical severity of the disease and outcome after surgical procedures were assessed (by both cleveland clinic incontinence scoring and Farag{u2019}s grading systems) and correlated to the physiologic parameters. Results: Anal canal length (ACL), anal canal diameter (ACD) and anal canal resistance (ACR) had significant correlations to the degree of incontinence (P<0.001). ACL, ACD and ACR showed statistical significant change with primary repair and gluteus maximus transposition operations. Also, ACL and ACR were increased significantly with dynamic plication P=0.024, 0.015 respectively