Graf W, Sonesson A-C, Lindberg B, Åkerud P, Karlbom U
Institution of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Neurogastroenterol Motil. 2015 May;27(5):734-9. doi: 10.1111/nmo.12546. Epub 2015 Mar 25.
Sacral nerve stimulation is an established treatment for fecal incontinence and initial reports describe successful results also in subjects with chronic constipation.
Consecutive patients with slow transit or outlet obstruction type constipation were offered external stimulation through a test electrode inserted in a sacral foramen during a 3-week period. The symptomatic evaluation was based on the number of bowel movements and a validated obstructed defecation score (ODS). A permanent implant was performed provided an overall 50% decrease in symptoms was observed.
In total, 44 patients with chronic constipation were treated with a 3-week test stimulation. Fifteen experienced a 50% reduction of symptoms and received a permanent implant. Four of the 15 with permanent implants were explanted during the course of the study. Five subjects (11% of original group) reported sustained symptom relief at final follow-up after a mean of 24 months (range 4-81). Mean ODS score did not change during the treatment. Patients with predominantly slow transit constipation or outlet obstruction did not differ concerning success rate.
CONCLUSIONS & INFERENCES: Sacral nerve stimulation has limited efficacy in unselected patients with chronic constipation and cannot be recommended for treatment on routine basis.
骶神经刺激是一种已确立的治疗大便失禁的方法，最初的报告描述了在慢性便秘患者中也取得了成功的治疗效果。
在为期3周的时间里，为连续入选的慢传输型或出口梗阻型便秘患者通过插入骶孔的测试电极进行外部刺激。症状评估基于排便次数和经过验证的排便梗阻评分（ODS）。如果观察到症状总体减轻50%，则进行永久性植入。
总共44例慢性便秘患者接受了为期3周的测试刺激。15例患者症状减轻了50%并接受了永久性植入。在研究过程中，15例接受永久性植入的患者中有4例被取出植入物。5例患者（占原始组的11%）在平均24个月（4 - 81个月）的最终随访中报告症状持续缓解。治疗期间平均ODS评分没有变化。以慢传输型便秘或出口梗阻为主的患者在成功率方面没有差异。
骶神经刺激在未经选择的慢性便秘患者中的疗效有限，不建议常规用于治疗。
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