Surgery for constipation: systematic review and practice recommendations

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...

Full description

Saved in:
Bibliographic Details
Published in:Colorectal disease 2017-09, Vol.19 (S3), p.92-100
Main Authors: Pilkington, S. A., Emmett, C., Knowles, C. H., Mason, J., Yiannakou, Y., Brown, Steven, Campbell, Kenneth, Chapman, Mark, Clarke, Andrew, Cruickshank, Neil, Dixon, Anthony, Grossi, Ugo, Hooper, Richard, Horrocks, Emma, Lacy‐Colson, Jon, Lindsey, Ian, Mercer‐Jones, Mark, Miller, Andrew, Pares, David, Smart, Neil, Stevens, Natasha, Tincello, Douglas, Telford, Karen, Vollebregt, Paul, Williams, Andrew
Format: Article
Language:English
Subjects:
Clinical trials
Constipation
Morbidity
neuromodulation
sacral nerve stimulation
Sacrum
slow transit constipation
Stimulation
Surgery
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary: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.
ISSN:1462-8910
1463-1318
DOI:10.1111/codi.13780