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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...
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| Published in: | Colorectal disease 2017-09, Vol.19 (S3), p.92-100 |
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| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , |
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| container_title | Colorectal disease |
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| creator | 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 |
| description | 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. |
| doi_str_mv | 10.1111/codi.13780 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_wiley</sourceid><recordid>TN_cdi_proquest_journals_1944264054</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1944264054</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1470-c38acf65a4e5f3eb6c9b95944c3b923b908295a67ce65d48481d0456219a49293</originalsourceid><addsrcrecordid>eNotUF1LwzAUDaLgnL74Cwo-d-Y2H018k_qxwWAP6nNI01Q61qYmraP_3qzzwuWeezicAwehe8AriPNoXNWsgOQCX6AFUE5SICAuZ5ylQgK-Rjch7DEGnoNYoPXH6L-tn5La-cS4LgxNr4fGdU9JmMJg2_iYxNvfxh4T3VVJ77WJlI2ccW1ru2qWh1t0VetDsHf_d4m-3l4_i3W63b1viudtaoDmODVEaFNzpqllNbElN7KUTFJqSCmzuFhkkmmeG8tZRQUVUGHKeAZSU5lJskQPZ9_eu5_RhkHt3ei7GKkg2mScYkajCs6qY3Owk-p902o_KcDqVJM61aTmmlSxe9nMiPwBD9JdBg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1944264054</pqid></control><display><type>article</type><title>Surgery for constipation: systematic review and practice recommendations</title><source>Wiley-Blackwell Read & Publish Collection</source><creator>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</creator><creatorcontrib>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</creatorcontrib><description>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.</description><identifier>ISSN: 1462-8910</identifier><identifier>EISSN: 1463-1318</identifier><identifier>DOI: 10.1111/codi.13780</identifier><language>eng</language><publisher>Chichester: Wiley Subscription Services, Inc</publisher><subject>Clinical trials ; Constipation ; Morbidity ; neuromodulation ; sacral nerve stimulation ; Sacrum ; slow transit constipation ; Stimulation ; Surgery</subject><ispartof>Colorectal disease, 2017-09, Vol.19 (S3), p.92-100</ispartof><rights>2017 The Authors. published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland</rights><rights>Copyright © 2017 The Association of Coloproctology of Great Britain and Ireland</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c1470-c38acf65a4e5f3eb6c9b95944c3b923b908295a67ce65d48481d0456219a49293</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids></links><search><creatorcontrib>Pilkington, S. A.</creatorcontrib><creatorcontrib>Emmett, C.</creatorcontrib><creatorcontrib>Knowles, C. H.</creatorcontrib><creatorcontrib>Mason, J.</creatorcontrib><creatorcontrib>Yiannakou, Y.</creatorcontrib><creatorcontrib>Brown, Steven</creatorcontrib><creatorcontrib>Campbell, Kenneth</creatorcontrib><creatorcontrib>Chapman, Mark</creatorcontrib><creatorcontrib>Clarke, Andrew</creatorcontrib><creatorcontrib>Cruickshank, Neil</creatorcontrib><creatorcontrib>Dixon, Anthony</creatorcontrib><creatorcontrib>Grossi, Ugo</creatorcontrib><creatorcontrib>Hooper, Richard</creatorcontrib><creatorcontrib>Horrocks, Emma</creatorcontrib><creatorcontrib>Lacy‐Colson, Jon</creatorcontrib><creatorcontrib>Lindsey, Ian</creatorcontrib><creatorcontrib>Mercer‐Jones, Mark</creatorcontrib><creatorcontrib>Miller, Andrew</creatorcontrib><creatorcontrib>Pares, David</creatorcontrib><creatorcontrib>Smart, Neil</creatorcontrib><creatorcontrib>Stevens, Natasha</creatorcontrib><creatorcontrib>Tincello, Douglas</creatorcontrib><creatorcontrib>Telford, Karen</creatorcontrib><creatorcontrib>Vollebregt, Paul</creatorcontrib><creatorcontrib>Williams, Andrew</creatorcontrib><title>Surgery for constipation: systematic review and practice recommendations</title><title>Colorectal disease</title><description>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.</description><subject>Clinical trials</subject><subject>Constipation</subject><subject>Morbidity</subject><subject>neuromodulation</subject><subject>sacral nerve stimulation</subject><subject>Sacrum</subject><subject>slow transit constipation</subject><subject>Stimulation</subject><subject>Surgery</subject><issn>1462-8910</issn><issn>1463-1318</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><recordid>eNotUF1LwzAUDaLgnL74Cwo-d-Y2H018k_qxwWAP6nNI01Q61qYmraP_3qzzwuWeezicAwehe8AriPNoXNWsgOQCX6AFUE5SICAuZ5ylQgK-Rjch7DEGnoNYoPXH6L-tn5La-cS4LgxNr4fGdU9JmMJg2_iYxNvfxh4T3VVJ77WJlI2ccW1ru2qWh1t0VetDsHf_d4m-3l4_i3W63b1viudtaoDmODVEaFNzpqllNbElN7KUTFJqSCmzuFhkkmmeG8tZRQUVUGHKeAZSU5lJskQPZ9_eu5_RhkHt3ei7GKkg2mScYkajCs6qY3Owk-p902o_KcDqVJM61aTmmlSxe9nMiPwBD9JdBg</recordid><startdate>201709</startdate><enddate>201709</enddate><creator>Pilkington, S. A.</creator><creator>Emmett, C.</creator><creator>Knowles, C. H.</creator><creator>Mason, J.</creator><creator>Yiannakou, Y.</creator><creator>Brown, Steven</creator><creator>Campbell, Kenneth</creator><creator>Chapman, Mark</creator><creator>Clarke, Andrew</creator><creator>Cruickshank, Neil</creator><creator>Dixon, Anthony</creator><creator>Grossi, Ugo</creator><creator>Hooper, Richard</creator><creator>Horrocks, Emma</creator><creator>Lacy‐Colson, Jon</creator><creator>Lindsey, Ian</creator><creator>Mercer‐Jones, Mark</creator><creator>Miller, Andrew</creator><creator>Pares, David</creator><creator>Smart, Neil</creator><creator>Stevens, Natasha</creator><creator>Tincello, Douglas</creator><creator>Telford, Karen</creator><creator>Vollebregt, Paul</creator><creator>Williams, Andrew</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>WIN</scope><scope>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>H94</scope></search><sort><creationdate>201709</creationdate><title>Surgery for constipation: systematic review and practice recommendations</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1470-c38acf65a4e5f3eb6c9b95944c3b923b908295a67ce65d48481d0456219a49293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Clinical trials</topic><topic>Constipation</topic><topic>Morbidity</topic><topic>neuromodulation</topic><topic>sacral nerve stimulation</topic><topic>Sacrum</topic><topic>slow transit constipation</topic><topic>Stimulation</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pilkington, S. A.</creatorcontrib><creatorcontrib>Emmett, C.</creatorcontrib><creatorcontrib>Knowles, C. H.</creatorcontrib><creatorcontrib>Mason, J.</creatorcontrib><creatorcontrib>Yiannakou, Y.</creatorcontrib><creatorcontrib>Brown, Steven</creatorcontrib><creatorcontrib>Campbell, Kenneth</creatorcontrib><creatorcontrib>Chapman, Mark</creatorcontrib><creatorcontrib>Clarke, Andrew</creatorcontrib><creatorcontrib>Cruickshank, Neil</creatorcontrib><creatorcontrib>Dixon, Anthony</creatorcontrib><creatorcontrib>Grossi, Ugo</creatorcontrib><creatorcontrib>Hooper, Richard</creatorcontrib><creatorcontrib>Horrocks, Emma</creatorcontrib><creatorcontrib>Lacy‐Colson, Jon</creatorcontrib><creatorcontrib>Lindsey, Ian</creatorcontrib><creatorcontrib>Mercer‐Jones, Mark</creatorcontrib><creatorcontrib>Miller, Andrew</creatorcontrib><creatorcontrib>Pares, David</creatorcontrib><creatorcontrib>Smart, Neil</creatorcontrib><creatorcontrib>Stevens, Natasha</creatorcontrib><creatorcontrib>Tincello, Douglas</creatorcontrib><creatorcontrib>Telford, Karen</creatorcontrib><creatorcontrib>Vollebregt, Paul</creatorcontrib><creatorcontrib>Williams, Andrew</creatorcontrib><collection>Wiley_OA刊</collection><collection>Wiley Online Library Journals</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pilkington, S. A.</au><au>Emmett, C.</au><au>Knowles, C. H.</au><au>Mason, J.</au><au>Yiannakou, Y.</au><au>Brown, Steven</au><au>Campbell, Kenneth</au><au>Chapman, Mark</au><au>Clarke, Andrew</au><au>Cruickshank, Neil</au><au>Dixon, Anthony</au><au>Grossi, Ugo</au><au>Hooper, Richard</au><au>Horrocks, Emma</au><au>Lacy‐Colson, Jon</au><au>Lindsey, Ian</au><au>Mercer‐Jones, Mark</au><au>Miller, Andrew</au><au>Pares, David</au><au>Smart, Neil</au><au>Stevens, Natasha</au><au>Tincello, Douglas</au><au>Telford, Karen</au><au>Vollebregt, Paul</au><au>Williams, Andrew</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgery for constipation: systematic review and practice recommendations</atitle><jtitle>Colorectal disease</jtitle><date>2017-09</date><risdate>2017</risdate><volume>19</volume><issue>S3</issue><spage>92</spage><epage>100</epage><pages>92-100</pages><issn>1462-8910</issn><eissn>1463-1318</eissn><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.</abstract><cop>Chichester</cop><pub>Wiley Subscription Services, Inc</pub><doi>10.1111/codi.13780</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1462-8910 |
| ispartof | Colorectal disease, 2017-09, Vol.19 (S3), p.92-100 |
| issn | 1462-8910 1463-1318 |
| language | eng |
| recordid | cdi_proquest_journals_1944264054 |
| source | Wiley-Blackwell Read & Publish Collection |
| subjects | Clinical trials Constipation Morbidity neuromodulation sacral nerve stimulation Sacrum slow transit constipation Stimulation Surgery |
| title | Surgery for constipation: systematic review and practice recommendations |
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