Sacral Neuromodulation in Treatment of Fecal Incontinence Following Anterior Resection and Chemoradiation for Rectal Cancer

Abstract

Fecal incontinence following anterior resection and neoadjuvant therapy should be carefully evaluated. If a suspected neurogenic pathogenesis is confirmed, sacral neuromodulation may be proposed. If the test results are positive, permanent implant is advisable. Failure of this approach does not exclude the use of other, more aggressive treatment.

Sacral nerve stimulation in patients with severe fecal incontinence after rectal resection

“…Sacral nerve stimulation (SNS) has been advocated as a safe and effective therapy for severe FI and shown to be associated with minimal morbidity [2]. In patients with FI after anterior resection (AR), SNS is has been used in few cases, with varying results [1,3].Between 2006 and 2009, four patients (one male, three female), with severe FI following neoadjuvant therapy and AR performed for rectal cancer, were treated in our hospital with SNS. The median age was 65.5 years (range 49-73 years).…”

“…Sacral nerve stimulation (SNS) has been advocated as a safe and effective therapy for severe FI and shown to be associated with minimal morbidity [2]. In patients with FI after anterior resection (AR), SNS is has been used in few cases, with varying results [1,3].…”

“…The risk is greater in patients with a resection less than 6-8 cm from the anal verge [1]. Sacral nerve stimulation (SNS) has been advocated as a safe and effective therapy for severe FI and shown to be associated with minimal morbidity [2].…”

Effects of Radiation Therapy for Rectal Cancer on Anorectal Function

“…Sacral neuromodulation has been advocated as a safe and effective therapy for severe fecal incontinence and shown to be associated with minimal morbidity [51,52]. In the literature, the experience with sacral neuromodulation in patients with fecal incontinence related to the anterior resection syndrome is still limited [53][54][55][56][57]. However, this minimally invasive therapeutic option been considered as the first choice in surgical treatment when conservative therapies fail [54][55][56].…”

Incontinence fécale et stimulation des racines sacrées

“…En ce qui concerne la stimulation sacrée utilisée à distance de la chirurgie, quelques études très préliminaires comportant un petit nombre de patients, rapportent des résultats satisfaisants de la stimulation sacrée, chez des patients devenus incontinents anaux après résection rectale pour cancer, avec ou sans radiothérapie associée [30][31][32][33].…”