OBJECTIVE To assess the efficacy and safety of sacral nerve modulation (SNM) in patients with faecal incontinence (FI) after pelvic radiotherapy in comparison with results of SNM for FI related to other conditions. METHODS Prospectively collected data from patients who underwent SNM therapy between January 2010 and December 2015 at 7 tertiary colorectal units were reviewed retrospectively. Patients with FI following pelvic radiotherapy were identified and matched (1:2) for age and sex with 38 patients implanted over the same period for FI without previous radiotherapy. The treatment was considered favourable if the patient reported any therapeutic benefit from SNM, had no further complaints or interventions and did not consider stopping the treatment. Long-term results, surgical revision and definitive explantation rates were compared. RESULTS Among 352 patients who received a permanent SNM implant, 19 (5.4%) had FI following pelvic radiotherapy. After a mean follow-up of 3.5 ± 1.9 years, the cumulative successful treatment rates were similar between the groups (p = 0.60). For patients with FI following pelvic radiotherapy, the cumulative success rates were 99.4% [85.4-99.8], 96.7% [78.1-99.6], 91.7% [70.4-98.1] and 74.6% [48.4-94.8] at 1, 2, 3 and 5 years respectively. The revision and definitive explantation rates for infection did not differ significantly. CONCLUSION The long-term success rate of SNM for FI after pelvic radiotherapy is similar to that of SNM for FI related to other more frequent conditions. Our study suggests that FI after pelvic radiotherapy could be improved with SNM without an increased risk of complication.

中文翻译：

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骶神经调制治疗盆腔放疗后大便失禁的疗效和安全性

目的 评估骶神经调制 (SNM) 在盆腔放疗后大便失禁 (FI) 患者中的有效性和安全性，并与 SNM 对其他疾病相关的 FI 的结果进行比较。方法前瞻性地收集了 2010 年 1 月至 2015 年 12 月期间在 7 个三级结直肠单位接受 SNM 治疗的患者的数据。确定盆腔放疗后 FI 患者的年龄和性别 (1:2)，其中 38 名患者在同一时期内植入 FI，未接受过放疗。如果患者报告从 SNM 中获得任何治疗益处，没有进一步的抱怨或干预，并且不考虑停止治疗，则认为治疗是有利的。对长期结果、手术翻修和根治性移植率进行了比较。结果 在接受永久性 SNM 植入的 352 名患者中，19 名（5.4%）在盆腔放疗后出现 FI。经过 3.5 ± 1.9 年的平均随访后，两组的累积成功治疗率相似（p = 0.60）。对于盆腔放疗后 FI 患者，1、2、3 日累积成功率分别为 99.4% [85.4-99.8]、96.7% [78.1-99.6]、91.7% [70.4-98.1] 和 74.6% [48.4-94.8]和 5 年。感染的修正率和明确的外植率没有显着差异。结论 盆腔放疗后 SNM 治疗 FI 的长期成功率与 SNM 治疗其他更常见疾病相关的 FI 的长期成功率相似。我们的研究表明，在不增加并发症风险的情况下，SNM 可以改善盆腔放疗后的 FI。