Is Sacral Neuromodulation Here to Stay? Clinical Outcomes of a New Treatment for Fecal Incontinence

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• 作者：Bobby L. Johnson III ; Adam Abodeely…
• 关键词：Sacral nerve stimulator ; Fecal incontinence ; Wexner score ; Sphincter injury ; Sacral neuromodulation
• 刊名：Journal of Gastrointestinal Surgery
• 出版年：2015
• 出版时间：January 2015
• 年：2015
• 卷：19
• 期：1
• 页码：15-20
• 全文大小：334 KB
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• 刊物主题：Surgery; Gastroenterology;
• 出版者：Springer US
• ISSN：1873-4626

文摘

Introduction Sacral neuromodulation (SNM) was approved by the FDA for the treatment of fecal incontinence (FI) in 2011, and previous industry-sponsored trials have shown excellent clinical outcomes. The purpose of this study is to examine clinical outcomes of patients treated during our initial experience with SNM. Methods A prospective database of patients treated with SNM for FI by one of three colorectal surgeons at two separate institutions was maintained starting in 2011. Patients showing ?0?% improvement of weekly incontinent episodes during test stimulation were offered permanent implantation of the SNM device. Disease severity was tracked using the Wexner score. Results A total of 145 patients received a full system implantation (of 152 who received test stimulation). The median preoperative Wexner score of 14 decreased to 3, 3?months after implantation and persisted to 12?months. At 12?months, 95.2?% of patients achieved >50?% improvement in Wexner Score and 67.6?% achieved >75?% improvement. The most common adverse event was infection (3.4?%). Three patients (2.1?%) required lead revision. Conclusions SNM is a safe and effective therapy for the treatment of FI. Postoperative patient surveillance is important, as many patients require programming changes, and some will require a lead revision over time.