Diagnostic accuracy of intraoperative pelvic autonomic nerve monitoring during rectal surgery: a systematic review.

Autor: O'Connor A; Department of Colorectal Surgery, Manchester University NHS Foundation Trust, Manchester, UK. alexander.oconnor@postgrad.manchester.ac.uk.; Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK. alexander.oconnor@postgrad.manchester.ac.uk., Rengifo C; Department of Colorectal Surgery, Manchester University NHS Foundation Trust, Manchester, UK., Griffiths B; Department of Colorectal Surgery, Manchester University NHS Foundation Trust, Manchester, UK., Cornish JA; Department of General Surgery, Cardiff and Vale University Health Board, Cardiff, UK., Tiernan JP; John Goligher Colorectal Unit, St James's University Hospital, Leeds, UK., Khan J; Department of Colorectal Surgery, Portsmouth Hospitals NHS Trust, Portsmouth, UK., Nunoo-Mensah JW; Department of Colorectal Surgery, King's College Hospital Foundation NHS Trust, London, UK., Telford K; Department of Colorectal Surgery, Manchester University NHS Foundation Trust, Manchester, UK.; Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PL, UK., Harji D; Department of Colorectal Surgery, Manchester University NHS Foundation Trust, Manchester, UK.
Jazyk: angličtina
Zdroj: Techniques in coloproctology [Tech Coloproctol] 2024 Dec 06; Vol. 29 (1), pp. 8. Date of Electronic Publication: 2024 Dec 06.
DOI: 10.1007/s10151-024-03043-w
Abstrakt: Purpose: Anorectal and urogenital dysfunctions are common after rectal surgery and have a significant impact on quality of life. Intraoperative pelvic autonomic nerve monitoring (pIONM) has been proposed as a tool to identify patients at risk of these functional sequelae. This systematic review aims to evaluate the diagnostic accuracy of pIONM in detecting anorectal and urogenital dysfunction following rectal surgery.
Methods: A systematic review of articles published since 1990 was conducted using MEDLINE, Embase, CINAHL, Google Scholar, Scopus, and Web of Science. Studies describing pIONM for rectal surgery and reporting anorectal or urogenital functional outcomes were included. The risk of bias was assessed using the QUADS-2 tool. The diagnostic accuracy of pIONM was established with pooled sensitivity and specificity alongside summary receiver-operating characteristic curves.
Results: Twenty studies including 686 patients undergoing pIONM were identified, with seven of these studies including a control group. There was heterogeneity in the pIONM technique and reported outcome measures used. Results from five studies indicate pIONM may be able to predict postoperative anorectal (sensitivity 1.00 [95% CI 0.03-1.00], specificity 0.98 [0.91-0.99]) and urinary (sensitivity 1.00 [95% CI 0.03-1.00], specificity 0.99 [0.92-0.99]) dysfunction.
Conclusions: This review identifies the diagnostic accuracy of pIONM in detecting postoperative anorectal and urogenital dysfunction following rectal surgery. Further research is necessary before pIONM can be routinely used in clinical practice.
Prospero Registration Details: CRD42022313934.
Competing Interests: Declarations. Conflict of interest: The authors declare no competing interests. Ethical Statement: This systematic review does not require ethical approval as it is not considered research after consultation with the United Kingdom HRA research decision tool. Consent Statement: Informed consent was not required for this systematic review.
(© 2024. The Author(s).)
Databáze: MEDLINE
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