Thomas G P, Bradshaw E, Vaizey C J
Sir Alan Parks Department of Physiology, St Mark's Hospital and Academic Institute, Harrow, UK.
Colorectal Dis. 2015 Nov;17(11):939-42. doi: 10.1111/codi.13069.
Faecal incontinence may occur following rectal surgery and/or radiotherapy for rectal cancer. The aim of this paper was to review the evidence to support the use of sacral nerve stimulation (SNS) for patients with incontinence who had undergone rectal surgery or received rectal radiotherapy.
A search was performed of PubMed, Medline and Embase. All studies which reported the outcome of SNS in patients who had undergone a rectal resection or radiotherapy were reviewed.
The first report of SNS following rectal surgery was in 2002. Since then seven further studies have described its effect in patients who have undergone anterior resection or pelvic radiotherapy. The total number of patients was 57. All studies were single group series, which ranged in size from one to 15 patients. The follow-up ranged from 1 to 36 months. The success of peripheral nerve evaluation ranged from 47% to 100%. Permanent SNS improved the symptoms and in some studies this was reflected in improved quality of life. The wide variation of patient factors, operations performed, the dose of radiotherapy given and time from operation makes interpretation of the results difficult.
Larger studies with better patient selection are needed to investigate the effect of SNS on incontinence following radiotherapy or rectal surgery.
直肠癌患者接受直肠手术和/或放疗后可能会出现大便失禁。本文旨在综述支持对接受过直肠手术或接受过直肠放疗的大便失禁患者使用骶神经刺激（SNS）的证据。
检索了PubMed、Medline和Embase。对所有报告SNS在接受直肠切除术或放疗患者中的结果的研究进行了综述。
2002年首次报道了直肠手术后的SNS。从那时起，又有七项研究描述了其在接受前切除术或盆腔放疗患者中的效果。患者总数为57例。所有研究均为单组系列研究，样本量从1例到15例不等。随访时间为1至36个月。周围神经评估的成功率在47%至100%之间。永久性SNS改善了症状，在一些研究中，这反映在生活质量的提高上。患者因素、所进行的手术、放疗剂量以及手术时间的广泛差异使得结果的解释变得困难。
需要进行更大规模、患者选择更优的研究，以调查SNS对放疗或直肠手术后大便失禁的影响。
