Clinical efficacy of lead revisions during the test phase in sacral neuromodulation for fecal incontinence
| Autor: | Stephanie O. Breukink, Paul T.J. Janssen, Jarno Melenhorst, Laurents P. S. Stassen, Nicole D. Bouvy |
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| Přispěvatelé: | Promovendi MHN, RS: NUTRIM - R2 - Liver and digestive health, RS: MHeNs - R3 - Neuroscience, MUMC+: MA Heelkunde (9), Surgery, MUMC+: MA AIOS Heelkunde (9), RS: SHE - R1 - Research (OvO) |
| Rok vydání: | 2019 |
| Předmět: |
Reoperation
Sacrum medicine.medical_specialty Lead revision Electric Stimulation Therapy 030230 surgery 03 medical and health sciences 0302 clinical medicine Fecal incontinence Internal medicine medicine Humans Defecation Lead (electronics) Adverse effect Electrodes NERVE-STIMULATION OUTCOMES business.industry Sacral neuromodulation Gastroenterology Middle Aged Hepatology Surgery Treatment Outcome Sacral nerve stimulation 030220 oncology & carcinogenesis Cohort Test phase medicine.symptom business |
| Zdroj: | International Journal of Colorectal Disease, 34(8), 1369-1374. Springer, Cham |
| ISSN: | 1432-1262 0179-1958 |
| DOI: | 10.1007/s00384-019-03325-y |
| Popis: | Background Success rates of up to 80% have been reported for the SNM screening period in the treatment of fecal incontinence (FI). Some patients who have an unsuccessful index implantation are successfully treated with SNM after a lead revision. There is a lack of studies comparing the outcomes of successful index implantations and successful lead revision. Therefore, the results of index implantations were compared with lead revisions in a single-center cohort.Methods Patients treated with SNM for FI between 2008 and 2016 were retrospectively reviewed. Patients with a successful index implantation were compared with patients who underwent lead revision after SNM screening. Primary outcome was a decrease in episodes of fecal incontinence of >= 50% documented by a 3-week bowel habit diary.Results Two hundred sixty-one patients (232 index group, 29 revision group) were eligible for SNM. Two hundred thirty-one patients (208 index group, 23 revision group) received permanent SNM. Follow-up was 68.8 months for the index group and 62.2 months for the revision group. The number of episodes of FI decreased from 20.6 (SD 19.3) to 3.4 (SD 4.2) in the index group and from 12.6 (SD 5.8) to 2.0 (SD 2.3) in the revision group. This effect was maintained up to 5 and 2 years in the index and revision group, respectively. Adverse events such as loss of efficacy which required surgical intervention did not differ between the two groups.Conclusion Lead revision during the test phase is a valid option in patients with FI treated by SNM who suffer from loss of efficacy of the index electrode. |
| Databáze: | OpenAIRE |
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