Wang M, Zhou W, Liu J, Liao Y, Liu B, Yu H
Institute of Rehabilitation Engineering and Technology, School of Health Science and Engineering, University of Shanghai for Science and Technology, Jungong Road 516, Shanghai, 200093, China.
Shanghai Engineering Research Center of Assistive Devices, Jungong Road 516, Shanghai, 200093, China.
Tech Coloproctol. 2024 Dec 2;29(1):6. doi: 10.1007/s10151-024-03034-x.
This study aimed to evaluate and compare the safety and efficacy of artificial anal sphincters in clinical practice.
A systematic review of literatures on artificial anal sphincters in PubMed, MEDLINE, EMBASE, Web of Science, and the Cochrane Library was performed. The literature was reviewed three times by several independent investigators, resulting in the identification of 47 studies that met the inclusion criteria. The primary outcomes of interest included adverse events, incontinence assessment, quality of life assessment, and anorectal manometry.
A total of 12 postoperative complications related to the implantation of the different artificial anal sphincters were reported. Four different incontinence rating scales and four quality of life scales were used to assess patients' fecal incontinence and improvement in quality of life. A total of 29 studies measured changes in patients' anorectal pressure before and after surgery.
In terms of safety, patients implanted with an artificial anal sphincter may develop complications such as pain, infection, defecation obstruction, and surgical revision. In terms of effectiveness, different artificial anal sphincters had significant effects on patients with fecal incontinence, but as a result of the insufficient sample size of the study, more relevant studies are needed for further validation in the future.
本研究旨在评估和比较人工肛门括约肌在临床实践中的安全性和有效性。
对PubMed、MEDLINE、EMBASE、科学网和考克兰图书馆中关于人工肛门括约肌的文献进行系统综述。文献由几位独立研究者进行了三次审查，最终确定了47项符合纳入标准的研究。感兴趣的主要结局包括不良事件、失禁评估、生活质量评估和肛肠测压。
共报告了12例与不同人工肛门括约肌植入相关的术后并发症。使用了四种不同的失禁评定量表和四种生活质量量表来评估患者的大便失禁情况和生活质量改善情况。共有29项研究测量了患者手术前后肛肠压力的变化。
在安全性方面，植入人工肛门括约肌的患者可能会出现疼痛、感染、排便梗阻和手术翻修等并发症。在有效性方面，不同的人工肛门括约肌对大便失禁患者有显著效果，但由于研究样本量不足，未来需要更多相关研究进行进一步验证。
