Changing paradigm of sacral neuromodulation and external anal sphincter repair for faecal incontinence in specialist centres

Ong K, Bordeianou L, Brunner M, Buntzen S, Collie MHS, Hanly A, Hunt CW, Matzel K, O'Connell PR, Rydningen M, Savitt L, Totaro A, Vaizey CJ, Maeda Y (2020)

Publication Type: Journal article

Publication year: 2020

Journal

Colorectal Disease Wiley

DOI: 10.1111/codi.15349

Abstract

Aim: The aim of this study was to determine whether the paradigm of surgical intervention for faecal incontinence (FI) has changed between 2000 and 2013. Method: This was a multi-centre retrospective study of patients who had undergone either sacral neuromodulation (SNM) or delayed sphincter repair or sphincteroplasty (SR) as a primary surgical intervention for FI in five centres in Europe and one in the United States. The flow of patients according to the intervention, sustainability of the treatment at a minimum follow-up of 5 years, complications and requirement for further interventions were recorded. Results: A total of 461 patients (median age 56 years, range 24–90 years, 41 men) had either SNM or SR as an index operation during the study period [SNM 284 (61.6%), SR 177 (38.4%)]. Among SNM patients, there were 169 revisional operations (change of battery and/or lead, re-siting or removal). At the time of last follow-up 203 patients (71.4%) continued to use SNM. Among SR patients, 30 (16.9%) had complications, most notably wound infection (22, 12.4%). During follow-up 32 patients (18.1%) crossed over to SNM. Comparing two 4-year periods (2000–2003 and 2007–2010), the proportion of patients operated on who had a circumferential sphincter defect of less than 90° was 48 (68%) and 45 (46%), respectively (P = 0.03), while those who had SNM as the primary intervention increased from 29% to 89% (P < 0.05). Conclusion: The paradigm of surgical intervention for FI has changed with increasing use of SNM.

Authors with CRIS profile

Maximilian Brunner Lehrstuhl für Allgemein- und Viszeralchirurgie Klaus Matzel Lehrstuhl für Allgemein- und Viszeralchirurgie

Involved external institutions

Western General Hospital GB United Kingdom (GB) St Vincent's University Hospital IE Ireland (IE) St. Mark's Hospital GB United Kingdom (GB) University Hospital of North Norway / Universitetssykehuset Nord-Norge (UNN) NO Norway (NO) Massachusetts General Hospital US United States (USA) (US)

How to cite

APA:

Ong, K., Bordeianou, L., Brunner, M., Buntzen, S., Collie, M.H.S., Hanly, A.,... Maeda, Y. (2020). Changing paradigm of sacral neuromodulation and external anal sphincter repair for faecal incontinence in specialist centres. Colorectal Disease. https://doi.org/10.1111/codi.15349

MLA:

Ong, Kelly, et al. "Changing paradigm of sacral neuromodulation and external anal sphincter repair for faecal incontinence in specialist centres." Colorectal Disease (2020).

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