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Techniques in Coloproctology
Published in: Techniques in Coloproctology 4/2014

01-04-2014 | Original Article

Efficacy of sacral nerve stimulation for poor functional results of J-pouch ileoanal anastomosis

Authors: A. Lebas, M. Rogosnitzky, C. Chater, J. F. Colombel, M. Nachury, A. Cortot, P. Zerbib

Published in: Techniques in Coloproctology | Issue 4/2014

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Abstract

Purpose

Ileoanal anastomoses (J-pouches) are an alternative to permanent ostomy. The functional outcomes associated with the use of J-pouches are usually good, but continence disorders persist in a significant number of cases and have a negative impact on quality of life. The aim of this study was to assess the efficacy of sacral nerve stimulation (SNS) for poor functional results after J-pouch ileoanal anastomosis.

Methods

Patients suffering from severe fecal incontinence (FI) following coloproctectomy underwent a staged implant SNS procedure. Demographic data and functional results for FI episodes, urgencies per week, frequency of stools, ability to defer defecation, and Wexner scores were obtained at specified intervals. Patients also completed quality-of-life assessments.

Results

Four female patients were included in this analysis. All 4 experienced active and passive FI at baseline and subsequently underwent test stimulation with a 75 % success rate. Three received definitive implants. These 3 patients experienced improvement in functional outcomes at 1, 3, and 6 month assessments. Improvements in quality of life were also noted.

Conclusions

Our preliminary study suggests that SNS is effective for the treatment of poor functional results following J-pouch ileoanal anastomosis; however, larger studies with long-term follow-up are needed for confirmation of our findings.
Literature
1.
McGuire BB, Brannigan AE, O’Connell PR (2007) Ileal pouch-anal anastomosis. Br J Surg 94:812–823PubMedCrossRef
2.
Ganschow P, Pfeiffer U, Hinz U, Leowardi C, Herfarth C, Kadmon M (2010) Quality of life ten and more years after restorative proctocolectomy for patients with familial adenomatous polyposis coli. Dis Colon Rectum 53:1381–1387PubMedCrossRef
3.
O’Bichere A, Wilkinson K, Rumbles S, Norton C, Green C, Phillips RK (2000) Functional outcome after restorative panproctocolectomy for ulcerative colitis decreases an otherwise enhanced quality of life. Br J Surg 87:802–807PubMedCrossRef
4.
Jorge JM, Wexner SD, Morgado PJ Jr, James K, Nogueras JJ, Jagelman DG (1994) Optimization of sphincter function after the ileoanal reservoir procedure. A prospective, randomized trial. Dis Colon Rectum 37:419–423PubMedCrossRef
5.
Norton C, Cody JD (2012) Biofeedback and/or sphincter exercises for the treatment of faecal incontinence in adults. Cochrane Database Syst Rev 7:CD002111
6.
Tulchinsky H, Hawley PR, Nicholls J (2003) Long-term failure after restorative proctocolectomy for ulcerative colitis. Ann Surg 238:229–234PubMedCentralPubMed
7.
Hull T, Giese C, Wexner SD et al (2013) Long-term durability of sacral nerve stimulation therapy for chronic fecal Incontinence. Dis Colon Rectum 56:234–245PubMedCrossRef
8.
Mellgren A, Wexner SD, Coller JA et al (2011) Long-term efficacy and safety of sacral nerve stimulation for fecal incontinence. Dis Colon Rectum 54:1065–1075PubMedCrossRef
9.
Carrington EV, Knowles CH (2011) The influence of sacral nerve stimulation on anorectal dysfunction. Colorectal Dis 13(Suppl 2):5–9PubMedCrossRef
10.
Gourcerol G, Vitton V, Leroi AM, Michot F, Abysique A, Bouvier M (2011) How sacral nerve stimulation works in patients with faecal incontinence. Colorectal Dis 13:e203–e211PubMedCrossRef
11.
Tjandra JJ, Chan MK, Yeh CH, Murray-Green C (2008) Sacral nerve stimulation is more effective than optimal medical therapy for severe fecal incontinence: a randomized, controlled study. Dis Colon Rectum 51:494–502PubMedCrossRef
12.
Ratto C, Grillo E, Parello A, Petrolino M, Costamagna G, Doglietto GB (2005) Sacral neuromodulation in treatment of fecal incontinence following anterior resection and chemoradiation for rectal cancer. Dis Colon Rectum 48:1027–1036PubMedCrossRef
13.
14.
Meurette G, Wong M, Paye F, Parc Y, Tiret E, Lehur PA (2011) Sacral nerve stimulation for the treatment of faecal incontinence after ileal pouch anal anastomosis. Colorectal Dis 13:e182–e183PubMedCrossRef
15.
Holzer B, Rosen HR, Zaglmaier W et al (2008) Sacral nerve stimulation in patients after rectal resection–preliminary report. J Gastrointest Surg 12:921–925PubMedCrossRef
16.
Moya P, Arroyo A, Soriano-Irigaray L, Frangi A, Candela Polo F, Calpena Rico R (2012) Sacral nerve stimulation in patients with severe fecal incontinence after rectal resection. Tech Coloproctol 16:263–264PubMedCrossRef
17.
Jorge JM, Wexner SD (1993) Etiology and management of fecal incontinence. Dis Colon Rectum 36:77–97PubMedCrossRef
18.
Leplege A, Ecosse E, Verdier A, Perneger TV (1998) The French SF-36 Health Survey: translation, cultural adaptation and preliminary psychometric evaluation. J Clin Epidemiol 51:1013–1023PubMedCrossRef
19.
Rullier E, Zerbib F, Marrel A, Amouretti M, Lehur PA (2004) Validation of the French version of the Fecal Incontinence Quality-of-Life (FIQL) scale. Gastroenterol Clin Biol 28:562–568PubMedCrossRef
20.
de Zeeuw S, Ahmed Ali U, Donders RA, Hueting WE, Keus F, van Laarhoven CJ (2012) Update of complications and functional outcome of the ileo-pouch anal anastomosis: overview of evidence and meta-analysis of 96 observational studies. Int J Colorectal Dis 27:843–853PubMedCentralPubMedCrossRef
21.
Wexner SD, Coller JA, Devroede G et al (2010) Sacral nerve stimulation for fecal incontinence: results of a 120-patient prospective multicenter study. Ann Surg 251:441–449PubMedCrossRef
22.
de Miguel M, Oteiza F, Ciga MA, Armendariz P, Marzo J, Ortiz H (2011) Sacral nerve stimulation for the treatment of faecal incontinence following low anterior resection for rectal cancer. Colorectal Dis 13:72–77PubMedCrossRef
23.
Ziv Y, Zbar A, Bar-Shavit Y, Igov I (2013) Low anterior resection syndrome (LARS): cause and effect and reconstructive considerations. Tech Coloproctol 17:151–162PubMedCrossRef
24.
Holzer B, Rosen HR, Novi G, Ausch C, Holbling N, Schiessel R (2007) Sacral nerve stimulation for neurogenic faecal incontinence. Br J Surg 94:749–753PubMedCrossRef
25.
Falletto E, Ganio E, Naldini G, Ratto C, Altomare DF (2013) Sacral neuromodulation for bowel dysfunction: a consensus statement from the Italian group. Tech Coloproctol. doi:10.​1007/​s10151-013-1002-2
26.
Miller R, Bartolo DC, Cervero F, Mortensen NJ (1988) Anorectal sampling: a comparison of normal and incontinent patients. Br J Surg 75:44–47PubMedCrossRef
27.
Williamson ME, Lewis WG, Finan P, Miller AS, Holdsworth PJ, Johnston D (1995) Recovery of physiologic and clinical function after low anterior resection of the rectum for carcinoma: myth or reality? Dis Colon Rectum 38:411–418PubMedCrossRef
28.
Miller R, Orrom WJ, Duthie G, Bartolo DC, Mortensen NJ (1990) Ambulatory anorectal physiology in patients following restorative proctocolectomy for ulcerative colitis: Comparison with normal controls. Br J Surg 77:895–897PubMedCrossRef
Metadata
Title
Efficacy of sacral nerve stimulation for poor functional results of J-pouch ileoanal anastomosis
Authors
A. Lebas
M. Rogosnitzky
C. Chater
J. F. Colombel
M. Nachury
A. Cortot
P. Zerbib
Publication date
01-04-2014
Publisher
Springer Milan
Published in
Techniques in Coloproctology / Issue 4/2014
Print ISSN: 1123-6337
Electronic ISSN: 1128-045X
DOI
https://doi.org/10.1007/s10151-013-1058-z

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