医学
回顾性队列研究
不利影响
外科
队列
骶神经电刺激
队列研究
大便失禁
前瞻性队列研究
内科学
作者
Charlotte Desprez,Henri Damon,G. Meurette,Diane Mège,Jean‐Luc Faucheron,Charlène Brochard,Elsa Lambrescak,Guillaume Gourcerol,François Mion,Vincent Wyart,I. Sielezneff,L. Siproudhis,Isabelle Etienney,Nadine Ajamie,Paul‐Antoine Lehur,Thomas Duflot,Valérie Bridoux,Anne‐Marie Leroi,Club Nemo
出处
期刊:Annals of Surgery
[Ovid Technologies (Wolters Kluwer)]
日期:2020-07-24
卷期号:275 (4): 735-742
被引量:8
标识
DOI:10.1097/sla.0000000000004251
摘要
Objective: The aim of this study was to assess the effectiveness of sacral nerve modulation (SNM) in a large cohort of patients implanted for at least 10 years, quantify adverse event rates, and identify predictive factors of long-term success. Summary Background Data: Few studies have evaluated the long-term success of SNM. Methods: Data collected prospectively from patients implanted for fecal incontinence (FI) in 7 French centers between January 1998 and December 2008 were retrospectively analyzed. Patient FI severity scores were assessed before and 10 years after implantation. The main evaluation criterion was the success of SNM defined by the continuation of the treatment without additional therapies. The secondary evaluation criteria were the rate of device revisions and explantations. Preoperative predictors of success at 10 years were sought. Results: Of the 360 patients (27 males, mean age: 59 ± 12 years) implanted for FI, 162 (45%) had a favorable outcome 10 years post-implantation, 115 (31.9%) failed, and 83 (23.1%) were lost to follow-up. The favorable outcome derived from the time-to-event Kaplan-Meier curve at 10 years was 0.64 (95% CI 0.58–0.69). FI severity scores were significantly better 10 years post-implantation compared to preimplantation (7.4 ± 4.3 vs 14.0 ± 3.2; P < 0.0001). During the 10-year follow-up, 233 patients (64.7%) had a surgical revision and 94 (26.1%) were explanted. A history of surgery for FI and sex (male) were associated with an increased risk of an unfavorable outcome. Conclusions: Long-term efficacy was maintained in approximately half of the FI patients treated by SNM at least 10 years post-implantation.
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