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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

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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
Subjects: R Medicine > RC Internal medicine
R Medicine > RD Surgery
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
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:
DateEvent
29 September 2017Published
19 September 2017Accepted
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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