Division of Colon and Rectal Surgery, University of Illinois, Chicago, Illinois, USA.
Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA.
Colorectal Dis. 2017 Oct;19(10):927-933. doi: 10.1111/codi.13701.
Sacral nerve stimulation has become a preferred method for the treatment of faecal incontinence in patients who fail conservative (non-operative) therapy. In previous small studies, sacral nerve stimulation has demonstrated improvement of faecal incontinence and quality of life in a majority of patients with low anterior resection syndrome. We evaluated the efficacy of sacral nerve stimulation in the treatment of low anterior resection syndrome using a recently developed and validated low anterior resection syndrome instrument to quantify symptoms.
A retrospective review of consecutive patients undergoing sacral nerve stimulation for the treatment of low anterior resection syndrome was performed. Procedures took place in the Division of Colon and Rectal Surgery at two academic tertiary medical centres. Pre- and post-treatment Cleveland Clinic Incontinence Scores and Low Anterior Resection Syndrome scores were assessed.
Twelve patients (50% men) suffering from low anterior resection syndrome with a mean age of 67.8 (±10.8) years underwent sacral nerve test stimulation. Ten patients (83%) proceeded to permanent implantation. Median time from anterior resection to stimulator implant was 16 (range 5-108) months. At a median follow-up of 19.5 (range 4-42) months, there were significant improvements in Cleveland Clinic Incontinence Scores and Low Anterior Resection Syndrome scores (P < 0.001).
Sacral nerve stimulation improved symptoms in patients suffering from low anterior resection syndrome and may therefore be a viable treatment option.
对于保守（非手术）治疗失败的粪便失禁患者，骶神经刺激已成为首选治疗方法。在之前的小型研究中，骶神经刺激已证明在大多数低位前切除综合征患者中改善了粪便失禁和生活质量。我们使用最近开发和验证的低位前切除综合征工具来量化症状，评估骶神经刺激治疗低位前切除综合征的疗效。
对在两个学术三级医疗中心的结肠和直肠外科进行骶神经刺激治疗低位前切除综合征的连续患者进行回顾性分析。评估了治疗前后克利夫兰诊所失禁评分和低位前切除综合征评分。
12 名（50%为男性）患有低位前切除综合征的患者，平均年龄为 67.8（±10.8）岁，进行了骶神经测试刺激。10 名患者（83%）进行了永久性植入。前切除至刺激器植入的中位数时间为 16 个月（范围 5-108）。在中位数为 19.5 个月（范围 4-42）的随访中，克利夫兰诊所失禁评分和低位前切除综合征评分均有显著改善（P<0.001）。
骶神经刺激改善了低位前切除综合征患者的症状，因此可能是一种可行的治疗选择。
