Lumi Carlos M, Muñoz Juan P, La Rosa Luciana
Unidad de Coloproctología, Departamento de Cirugía, Hospital de Gastroenterología Dr Carlos Bonorino Udaondo, Av. Caseros 2061 (1264) Ciudad Autónoma de Buenos Aires, Argentina.
Acta Gastroenterol Latinoam. 2007 Mar;37(1):29-36.
Anal incontinence is a severe physical and emotional condition that affects quality of life. Its treatment with neuromodulation, that consists in sacral roots electrical stimulation, has became a therapeutic option.
This study was designed to present the surgical technique and the first prospective experience in neuromodulation for fecal incontinence in Argentina.
Four females with severe fecal incontinence (mean score 17/20) were included. Anorectal physiology testing and anal ultrasound were performed before surgery. Due to failed medical treatment and the presence of an intact anal sphincter, sacral neuromodulation was indicated. After temporary sacral nerve evaluation, definitive neuromodulator was implanted.
After 13 months the incontinence score and the number of weekly escapes decrese from 17/20 to 1.7/20 (p = 0.059) and from 62 to 0.2 (p = 0.059). Quality of life scores also improves but not statiscally significative.
Sacral neuromodulation in fecal incontinence is useful. It is effective in patients who had failed maximum conservative therapies with the advantage of testing before definitive.
肛门失禁是一种严重的身体和情绪状况，会影响生活质量。通过神经调节进行治疗，即骶神经根电刺激，已成为一种治疗选择。
本研究旨在介绍阿根廷用于治疗大便失禁的神经调节手术技术及首次前瞻性经验。
纳入4名严重大便失禁的女性患者（平均评分17/20）。术前进行了肛肠生理测试和肛门超声检查。由于药物治疗无效且肛门括约肌完整，故采用骶神经调节治疗。在进行临时骶神经评估后，植入了永久性神经调节器。
13个月后，失禁评分和每周排便失控次数从17/20降至1.7/20（p = 0.059），从62次降至0.2次（p = 0.059）。生活质量评分也有所提高，但无统计学意义。
骶神经调节治疗大便失禁是有效的。对于最大程度保守治疗无效的患者，它具有在确定性治疗前进行测试的优势。
