{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T18:11:27Z","timestamp":1757700687383,"version":"3.37.3"},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,1,5]],"date-time":"2017-01-05T00:00:00Z","timestamp":1483574400000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Overlapping anal sphincter repair (OASR) is used for treatment of faecal incontinence due to an external anal sphincter (EAS) defect; however, it is not the optimal treatment as its functional results tend to deteriorate significantly with time. The present study aimed to evaluate the effect of local injection of bone marrow aspirate concentrate (BMAC) on the outcome of OASR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We compared a prospective group of 20 patients with EAS defect who were managed with OASR and BMAC injection (group I) with a historical control group of an equal number of patients managed with OASR alone (group II). Patients were assessed preoperatively and during follow\u2010up by the Wexner continence score and endoanal ultrasound. The primary end\u2010points were the improvement of the continence level measured by the Wexner score and the residual EAS defect size measured by endoanal ultrasound.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At the end of follow\u2010up, group I had significantly lower mean postoperative Wexner score (5.4\u00a0\u00b1\u00a07.6 <jats:italic>vs<\/jats:italic> 10.6\u00a0\u00b1\u00a07.4; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.03) and smaller EAS defect percentage (12.2\u00a0\u00b1\u00a017.5 <jats:italic>vs<\/jats:italic> 18.3\u00a0\u00b1\u00a018.9). These findings were statistically significant in patients with a small preoperative EAS defect equal to or less than one\u2010third of the anal circumference. Patients with larger preoperative EAS did not show a significant improvement of the continence level after repair in either group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Augmenting OASR with local injection of BMAC in patients with faecal incontinence caused by an EAS defect, particularly a smaller defect, can improve both functional and anatomical outcomes of OASR.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.13579","type":"journal-article","created":{"date-parts":[[2016,12,10]],"date-time":"2016-12-10T14:14:35Z","timestamp":1481379275000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Evaluation of anatomical and functional results of overlapping anal sphincter repair with or without the injection of bone marrow aspirate concentrate: a case\u2013control study"],"prefix":"10.1111","volume":"19","author":[{"given":"W. W.","family":"Khafagy","sequence":"first","affiliation":[{"name":"General Surgery Department Mansoura Faculty of Medicine Mansoura University Mansoura City Dakahlia Providence Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M. M.","family":"El\u2010Said","sequence":"additional","affiliation":[{"name":"General Surgery Department Mansoura Faculty of Medicine Mansoura University Mansoura City Dakahlia Providence Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W. M.","family":"Thabet","sequence":"additional","affiliation":[{"name":"General Surgery Department Mansoura Faculty of Medicine Mansoura University Mansoura City Dakahlia Providence Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. 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T.","family":"El\u2010Shobaky","sequence":"additional","affiliation":[{"name":"General Surgery Department Mansoura Faculty of Medicine Mansoura University Mansoura City Dakahlia Providence Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,1,5]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp067041"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02554596"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)05218-6"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-6180-6"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-003-0114-6"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.12579"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/uog.920"},{"key":"e_1_2_8_9_1","first-page":"CD002866","article-title":"Methods of repair for 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