Duelund-Jakobsen Jakob, Lehur Paul-Antoine, Lundby Lilli, Wyart Vincent, Laurberg Søren, Buntzen Steen
Int J Colorectal Dis. 2016 Feb;31(2):421-8. doi: 10.1007/s00384-015-2411-7. Epub 2015 Oct 21.
Sacral nerve stimulation (SNS) has been recognised as an effective treatment for faecal incontinence. Many unresolved questions could be answered when comparing large data-series from different centres providing prospective data.
To present data, from an international two-centre SNS prospective database (SNSPD) on functional outcome and management of surgical complications in patients treated with SNS for faecal incontinence.
The SNSPD was designed in order to gather detailed pre- and perioperative information followed by a close follow-up in all patients undergoing SNS for bowel dysfunction. The SNSPD was open for inclusion of newly SNS implanted patients in May 2009, and closed on 31 December 2013. Two-centres Aarhus, Denmark, and Nantes, France, included and monitored all patients implanted due to bowel dysfunction according to database criteria.
In total, 164 faecal incontinent patients with a median follow-up of 22 (range 1-50) months were implanted. The Wexner incontinence score improved from 15 (range, 3-20) at baseline to 9 (range, 0-20) at latest follow-up (P < 0.001) and VAS impact on daily life improved from 85.5 (range, 3-100) to 20 (range, 0-100) (P < 0.001). Additional surgical intervention was required in 19.5 % during follow-up. Repositioning of the pacemaker due to pain or migration was the most common complication in 12.1 %. Infections leading to explantation occurred in 3.0 %.
骶神经刺激(SNS)已被公认为是治疗大便失禁的有效方法。比较来自不同中心提供前瞻性数据的大型数据集时,许多未解决的问题都可以得到解答。
展示来自国际双中心SNS前瞻性数据库(SNSPD)的数据,内容涉及接受SNS治疗大便失禁患者的功能结局及手术并发症的处理。
设计SNSPD是为了收集详细的术前和围手术期信息,随后对所有接受SNS治疗肠功能障碍的患者进行密切随访。SNSPD于2009年5月开始纳入新植入SNS的患者,并于2013年12月31日结束。丹麦奥胡斯和法国南特这两个中心根据数据库标准纳入并监测所有因肠功能障碍而植入的患者。
总共为164例大便失禁患者植入了装置,中位随访时间为22(范围1 - 50)个月。Wexner失禁评分从基线时的15(范围3 - 20)改善至最近一次随访时的9(范围0 - 20)(P < 0.001),日常生活VAS影响评分从85.5(范围3 - 100)改善至20(范围0 - 100)(P < 0.001)。随访期间19.5%的患者需要额外的手术干预。因疼痛或移位而重新放置起搏器是最常见的并发症,占12.1%。导致移除装置的感染发生率为3.0%。