骶神经调节治疗大便失禁：年龄对疗效和并发症的影响。一项多中心研究。
Sacral nerve modulation for faecal incontinence: influence of age on outcomes and complications. A multicentre study.
机构信息
Department of Digestive Surgery, Assistance Publique Hôpitaux de Marseille, Timone University Hospital, Marseille, France.
Digestive and Endocrine Surgery Clinic, Diseases of the Digestive Tract Institute, University Hospital of Nantes, Nantes, France.
出版信息
Colorectal Dis. 2019 Sep;21(9):1058-1066. doi: 10.1111/codi.14649. Epub 2019 May 18.
AIM
Faecal incontinence is frequent in the elderly. Little is currently known about the efficacy of sacral nerve modulation (SNM) in the elderly. The present study aimed to assess the impact of age on the outcome of SNM and on the surgical revision and explantation rates by comparing the results of a large data set of patients.
METHOD
Prospectively collected data from patients who underwent an implant procedure between January 2010 and December 2015 in seven French centres were retrospectively evaluated. In total, 352 patients [321 women; median age (range): 63 (24-86) years] were included. Clinically favourable and unfavourable outcomes, and surgical revision and explantation rates, were compared according to the age of the patients.
RESULTS
A similar outcome was observed when comparing patients < 70 years and ≥ 70 years (a favourable outcome in 79.2% and 76.2%, respectively, P = 0.89). The probability of a successful treatment as a function of time was similar for the two age groups (< 70 years and ≥ 70 years, P = 0.54). The explantation and revision rates were not influenced by age (explantation rate: 17% in patients < 70 years vs 14% in patients ≥ 70 years, P = 0.89; and revision rate: 42% in patients < 70 years vs 40% in patients ≥ 70 years, P = 0.89). The probability of explantation as a function of time was similar for the two age groups (P = 0.82). The limitations of this study were its retrospective status, the rate of loss at follow-up and different durations of patient follow-up.
CONCLUSIONS
Our results suggest that patients ≥ 70 years suffering from faecal incontinence benefit from SNM with a similar risk as a younger population.
目的
老年人中经常出现粪便失禁。目前对于骶神经调节（SNM）在老年人中的疗效知之甚少。本研究旨在通过比较大量患者数据的结果，评估年龄对 SNM 结果以及手术修正和取出率的影响。
方法
回顾性评估了 2010 年 1 月至 2015 年 12 月在法国七个中心接受植入手术的患者的前瞻性收集数据。共纳入 352 例患者[321 例女性；中位年龄（范围）：63（24-86）岁]。根据患者的年龄比较了临床有利和不利结局以及手术修正和取出率。
结果
比较<70 岁和≥70 岁的患者时，观察到相似的结果（分别为 79.2%和 76.2%的有利结局，P=0.89）。两组患者的治疗成功率随时间的变化趋势相似（<70 岁组和≥70 岁组，P=0.54）。年龄不影响取出和修正率（<70 岁患者的取出率为 17%，≥70 岁患者为 14%，P=0.89；<70 岁患者的修正率为 42%，≥70 岁患者为 40%，P=0.89）。两组患者随时间的取出概率相似（P=0.82）。本研究的局限性在于其回顾性状态、随访丢失率和不同的患者随访时间。
结论
我们的结果表明，患有粪便失禁的≥70 岁患者受益于 SNM，其风险与年轻人群相似。
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