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Surgery for constipation : systematic review and practice recommendations : Results V: Sacral Nerve Stimulation
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The Pelvic floor Society, National Institute for Health Research: Chronic Constipation Treatment Pathway (Including: Pilkington, S. A., Emmett, C., Knowles, C. H., Mason, James and Yiannakou, Y.). (2017) Surgery for constipation : systematic review and practice recommendations : Results V: Sacral Nerve Stimulation. Colorectal Disease, 19 (S3). pp. 92-100. doi:10.1111/codi.13780
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Official URL: http://dx.doi.org/10.1111/codi.13780
Abstract
Aim
To assess the outcomes of sacral nerve stimulation in adults with chronic constipation.
Method
Standardised methods and reporting of benefits and harms were used for all CapaCiTY reviews that closely adhered to PRISMA 2016 guidance. Main conclusions were presented as summary evidence statements with a summative Oxford Centre for Evidence-Based Medicine (2009) level.
Results
Seven articles were identified, providing data on outcomes in 375 patients. Length of procedures and length of stay was not reported. Data on harms were inconsistently reported and heterogeneous, making estimates of harm tentative and imprecise. Morbidity rates ranged between 13 and 34%, with overall device removal rate between 8 and 23%. Although inconsistently reported, pooled treatment success was typically 57–87% for patients receiving permanent implants, although there was significant variation between studies. Patient selection was inconsistently documented. No conclusions could be drawn regarding particular phenotypes that responded favourably or unfavourably to sacral nerve stimulation.
Conclusion
Evidence supporting sacral nerve stimulation is derived from poor quality studies. Three methodologically robust trials are have reported since this review and all have all urged greater caution.
| Item Type: | Journal Article | ||||||
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| Subjects: | R Medicine > RC Internal medicine R Medicine > RD Surgery |
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| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Constipation -- Treatment -- Standards, Surgery, Nerves, Sacral | ||||||
| Journal or Publication Title: | Colorectal Disease | ||||||
| Publisher: | Wiley-Blackwell Publishing, Inc. | ||||||
| ISSN: | 1462-8910 | ||||||
| Official Date: | 29 September 2017 | ||||||
| Dates: |
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| Volume: | 19 | ||||||
| Number: | S3 | ||||||
| Page Range: | pp. 92-100 | ||||||
| DOI: | 10.1111/codi.13780 | ||||||
| Status: | Peer Reviewed | ||||||
| Publication Status: | Published | ||||||
| Access rights to Published version: | Open Access | ||||||
| Funder: | National Institute for Health Research (Great Britain) (NIHR) | ||||||
| Grant number: | RP-PG-0612-20001 |
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