Sacral neuromodulation for fecal incontinence in Latin America: initial results of a multicenter study
| Autor: | E. Londoño-Schimmer, J. A. C. Siachoque, G. Hagerman, Sthela Maria Murad Regadas, S. D. Wexner, J. Perez-Aguirre, J. C. Reyes, D. Lima, M. L. Torres, V. G. Filho, G. Rosato, L. Marzan, L. Oliveira, V. H. Guerrero-Guerrero, E. Vieira, C. M. Lumi, J. C. Sanchez-Robles |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Sacrum medicine.medical_specialty Electric Stimulation Therapy Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Hematoma Endoanal ultrasound medicine Humans Fecal incontinence Device Removal Aged Retrospective Studies Aged 80 and over business.industry Gastroenterology Retrospective cohort study Middle Aged medicine.disease Colorectal surgery Electrodes Implanted Surgery Latin America Treatment Outcome 030220 oncology & carcinogenesis Etiology Female 030211 gastroenterology & hepatology Implant medicine.symptom business Fecal Incontinence Abdominal surgery |
| Zdroj: | Techniques in Coloproctology. 23:545-550 |
| ISSN: | 1128-045X 1123-6337 |
| Popis: | Sacral neuromodulation (SNM) is a widely used therapeutic option for fecal incontinence (FI). Larger series are mainly from Western countries, while few reports address the results of SNM in less developed or less wealthy countries. The aim of the present study was to evaluate the efficacy of SNM in patients with FI in Latin America. A retrospective study was conducted on patients with FI who had SNM between 2009 and 2016 at 15 specialized colorectal surgery centers in Latin America. Main outcomes measures were functional outcomes, postoperative complications, requirement of revisional surgery, and requirement of device removal. All patients had failed conservative management and had clinical assessment including recording of the validated Cleveland Clinic Florida Fecal Incontinence Score (CCF-FIS) and, when available, anal manometry and endoanal ultrasound. Patients were followed up for a median of 36.7 (1–84) months. One hundred and thirty-one patients [119 females, median age of 62.2 (range 19–87) years] were included. The most common etiology of FI was obstetric injury (n = 60; 45.8%). After successful test lead implantation, the stimulator was permanently placed in 129 patients (98.5%). One patient failed to respond in the test phase and one patient did not proceed to permanent implantation for insurance reasons. Nineteen patients (14.7%) had 19 complications including infection (n = 5, 3.8%), persistent implant site pain (n = 5, 3.8%), generator/lead dislodgment (n = 5, 3.8%), malfunctioning device (n = 3, 2.3%), and hematoma (n = 1, 0.7%). Reimplantation after the first and second stages was necessary in 2 (1.5%) and 3 patients (2.3%), respectively. The device removal rate was 2.2%. At a median follow-up of 36.7 (range 1–84) months, the CCF-FIS significantly improved from a preoperative baseline of 15.9 ± 2.98 to 5.2 ± 3.92 (95%CI: 15.46 vs 4.43; p |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink