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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

자료유형
학술저널
저자정보
Bernhard Widmann (Department of General Visceral Endocrine and Transplantation Surgery Kantonsspital St. Gallen) Christian Galata (Department of Surgery University Medical Center Mannheim University of Heidelberg Germany) Rene Warschkow (Institute of Medical Biometry and Informatics University of Heidelberg Germany) Ulrich Beutner (Department of General Visceral Endocrine and Transplantation Surgery Kantonsspital St. Gallen) Önder Ögredici (Department of General Visceral Endocrine and Transplantation Surgery Kantonsspital St. Gallen) Franc H Hetzer (Department of Surgery Spital Linth Uznach Switzerland) Bruno M Schmied (Department of General Visceral Endocrine and Transplantation Surgery Kantonsspital St. Gallen) Stefan Post (Department of Surgery University Medical Center Mannheim University of Heidelberg Germany) Lukas Marti (Department of General Visceral Endocrine and Transplantation Surgery Kantonsspital St. Gallen)
저널정보
대한소화관운동학회(현 대한소화기능성질환.운동학회) Journal of Neurogastroenterology and Motility (JNM) Journal of Neurogastroenterology and Motility (JNM) Vol.25 No.1
발행연도
2019.1
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159 - 170 (12page)

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Background/Aims: The aim of this study was to evaluate the sustainability of sacral neuromodulation (SNM) success in patients with fecal incontinence (FI) and/or constipation. Methods: This is a retrospective analysis of a prospective database of patients who received SNM therapy for FI and/or constipation between 2006 and 2015. Success rates, complications and reintervention rates were assessed after up to 10 years of follow-up. Results: Electrodes for test stimulation were implanted in 101 patients, of whom 79 (78.2%) received permanent stimulation. The mean follow-up was 4.4 ± 3.0 years. At the end of follow-up, 57 patients (72.2%) were still receiving SNM. The 5-year success rate for FI and isolated constipation was 88.2% (95% confidence interval [CI], 80.1–97.0%) and 31.2% (95% CI, 10.2–95.5%), respectively (P < 0.001). In patients with FI, involuntary evacuations per week decreased > 50% in 76.1% of patients (95% CI, 67.6–86.2%) after 5 years. A lead position at S3 was associated with an improved outcome (P = 0.04). Battery exchange was necessary in 23 patients (29.1%), with a median battery life of 6.2 years. Reinterventions due to complications were necessary in 24 patients (30.4%). For these patients, the 5-year success rate was 89.0% (95% CI, 75.3–100.0%) compared to 78.4% (95% CI, 67.2–91.4%) for patients without reintervention. Conclusions: SNM offers an effective sustainable treatment for FI. For constipation, lasting success of SNM is limited and is thus not recommended. Reinterventions are necessary but do not impede treatment success.
#Constipation #Electric stimulation #Fecal incontinence #Sacral nerve stimulation #Sacral neuromodulation

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참고문헌 (44)

참고문헌 신청
Ng KS / 2015 / Fecal incontinence : community prevalence and associated factors-a systematic review / Dis Colon Rectum 58:1194~1209 google schola Stewart WF / 1999 / Epidemiology of constipation(EPOC)study in the United States : relation of clinical subtypes to sociodemographic features / Am J Gastroenterol 94:3530~3540 google schola Everhart JE / 2009 / Burden of digestive diseases in the United States part II : lower gastrointestinal diseases / Gastroenterology 136:741~754 google schola Ganio E / 2001 / Short-term sacral nerve stimulation for functional anorectal and urinary disturbances : results in 40 patients : evaluation of a new option for anorectal functional disorders / Dis Colon Rectum 44:1261~1267 google schola Matzel KE / 1995 / Electrical stimulation of sacral spinal nerves for treatment of faecal incontinence / Lancet 346:1124~1127 google schola

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