Sacral neuromodulation improves functional outcome and quality of life in patients with pouch dysfunction after pan proctocolectomy for ulcerative colitis.
F Drissi, M Di Giuseppe, C Korkmaz, A Bourreille, X Tréton, F Ris, G Meurette
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引用次数: 0
Abstract
Background: Postoperative frequency of bowel movements and impaired fecal continence (FI) has a negative impact on quality of life following ileal pouch-anal anastomosis. Sacral neuromodulation (SNM) is a validated treatment of FI, but its effectiveness in patients with ileal pouch-anal anastomosis (IPAA) has been poorly reported. The aim was to assess the results of SNM in patients with IPAA suffering from functional disorders and to compare these results with those of patients routinely treated by SNM for FI.
Methods: A 3-week test phase was performed before definitive implantation of the pulse generator. Patients' data were prospectively gathered in a dedicated registry. Patients with IPAA were then compared with a matched-paired control group of patients routinely treated by SNM for FI.
Results: Between 2007 and 2020, 14 patients with IPAA were tested and 12 (85%) were implanted. This group was compared with a matched group of 20 patients implanted for FI. After a mean follow-up of 4.8 [0.5-16] years, there was a significant decrease of weekly leaks (29 versus 2; p = 0.01), decrease in Wexner score (15 versus 10.8; p = 0.01), and an improvement in quality of life (fecal incontinence quality of life (FIQOL) 1.853 versus 2.42; p = 0.01). Patients with IPAA evolved equally as compared with the control group in terms of Wexner score and quality of life at 6 months, 1 year, and 2 years.
Conclusions: SNM provides a significant decrease of leaks and improves Wexner scores and quality of life in patients with IPAA. The effectiveness seems comparable to patients routinely treated by SNM for FI. SNM indications could be extended to patients with IPAA who present with bad functional outcome.
期刊介绍：
Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.
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