A systematic review of sacral nerve stimulation for low anterior resection syndrome

Ramage, Lisa; Qiu, Shihui; Kontovounisios, Christos; Tekkis, Paris; Rasheed, Shahnawaz; Tan, Ek Khoon

doi:10.1111/codi.12968

Cited by 93 publications

(83 citation statements)

References 25 publications

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“…This improvement is of paramount importance for patients' QoL and is reflected in the improved LARS scores after SNS treatment. The initial treatment response in our study is in line with previous studies . Eighty‐three per cent (10/12) of our patients qualified for permanent implant.…”

Section: Discussionsupporting

confidence: 90%

Sacral nerve stimulation can be an effective treatment for low anterior resection syndrome

et al. 2017

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Section: Discussionsupporting

confidence: 90%

Sacral nerve stimulation can be an effective treatment for low anterior resection syndrome

et al. 2017

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“…As these patients have altered anatomy after resection of the rectum, it is unclear how much benefit SNM may play in achieving relief of symptoms. Two separate studies were conducted on the utility of SNS in LARS . Success was noted in 47‐100% of patients subjected to a test implantation and QOL was generally improved .…”

Section: Fecal Incontinence (Fi)mentioning

confidence: 99%

International Continence Society best practice statement for use of sacral neuromodulation

Goldman

Lloyd

Noblett

et al. 2018

Neurourology and Urodynamics

138

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“…18 the mechanism of action of sns was initially thought to be a direct effect on the anal sphincters to increase resting and squeeze pressures. however, the initial hypothesis that the mechanism of sns was primarily peripheral motor neurostimulation is not supported by the majority of recent studies.…”

Section: Treatment Algorithmmentioning

confidence: 99%

Low Anterior Resection Syndrome

Martellucci

2016

Diseases of the Colon &Amp; Rectum

130

112

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f or almost 100 years abdominoperineal excision has been the standard treatment of choice for rectal cancer. however, as miles said, "the operation is a severe one. i do not think that it should be performed on those over 60 years of age; of 10 such cases all died. With regard to the remainder, of whom there were 36, 8 died from the effects of the operation, 4 have had recurrence, 2 died of intercurrent disease, while 22 are alive and well after periods varying from six months to six years." 1 the conviction that the quality of life for patients with a colostomy after abdominoperineal excision was poorer than for patients undergoing an operation with a sphincterpreserving technique has meant that, over the past 20 years, the anterior resection with preservation of the sphincter function has become the preferred treatment for rectal cancers, with the exception of those cancers very close to the anal sphincter.to date, also thanks to the multimodal treatment of rectal cancer, sphincter-preserving surgery with the restoration of bowel continuity to avoid a permanent colostomy is feasible in up to 80% of these patients. however, patients having sphincter-preserving operations may experience symptoms affecting their quality of life that are different from stoma patients and the question of whether the quality of life of people after anterior resection is superior to that of people after abdominoperineal excision/hartmann operation has yet to be answered.in fact, up to 80% of patients undergoing a low or very low anterior resection will experience postoperatively a constellation of symptoms including fecal urgency, frequent bowel movements, bowel fragmentation, emptying difficulties and incontinence, increased gas, collectively referred to as the low anterior resection syndrome (laRs).even if most of the functional impairments are clinically recovered by 6 to 12 months after the operation, longterm studies are now reporting the presence of adverse symptoms up to 15 years after resection. these long-term results suggest that after about 12 months, the symptoms of anterior resection syndrome are the result of permanent changes rather than short-lived neorectal irritability in the postoperative period. 2 Bowel dysfunction is a major problem with an immense impact on quality of life following sphincter-preserving resection, and the quality of life of patients who have had rectal cancer is closely associated with the severity of the laRs. 3 impaired bowel function is usually provoked by the variable association of colonic dysmotility, neorectal reservoir dysfunction, and anal sphincter or pelvic nerves damage.there are currently no specific treatments for anterior resection syndrome. management is empirical and symptom based, using existing therapies for fecal incontinence, fecal urgency, and rectal evacuatory disorders. moreover, rectal cancer specialists do not have a very thorough understanding of which bowel dysfunction symptoms truly matter to the patient after sphincter-preserving treatment, or how these symptoms affe...

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A systematic review of sacral nerve stimulation for low anterior resection syndrome

Abstract: The review suggests that SNS for faecal incontinence in LARS has success rates comparable to its use for other forms of faecal incontinence.

Cited by 93 publications

References 25 publications

Sacral nerve stimulation can be an effective treatment for low anterior resection syndrome

Sacral nerve stimulation can be an effective treatment for low anterior resection syndrome

International Continence Society best practice statement for use of sacral neuromodulation

Low Anterior Resection Syndrome

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