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Sacral neuromodulation in children and adolescents with chronic constipation refractory to conservative treatment.
van der Wilt, Aart A; van Wunnik, Bart P W; Sturkenboom, Rosel; Han-Geurts, Ingrid J; Melenhorst, Jarno; Benninga, Marc A; Baeten, Cor G M I; Breukink, Stephanie O.
Afiliación
  • van der Wilt AA; Department of Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands. aartvanderwilt@hotmail.com.
  • van Wunnik BP; Department of Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands.
  • Sturkenboom R; Department of Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands.
  • Han-Geurts IJ; Department of Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands.
  • Melenhorst J; Department of Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands.
  • Benninga MA; Department of Pediatric Gastroenterology, Academic Medical Center, Amsterdam, The Netherlands.
  • Baeten CG; Department of Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands.
  • Breukink SO; Department of Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6202 AZ, Maastricht, The Netherlands.
Int J Colorectal Dis ; 31(8): 1459-66, 2016 Aug.
Article en En | MEDLINE | ID: mdl-27294660
PURPOSE: Functional constipation in children and adolescents is a common and invalidating condition. In a minority of patients, symptoms persist despite optimal conservative therapy. The aim of this study was to evaluate whether the short-term effects of sacral neuromodulation (SNM) in children and adolescents with constipation are sustained over prolonged period of time. METHODS: Patients aged 10-20 years, with refractory constipation, fulfilling the Rome III criteria, were included in our study. If SNM test treatment showed >50 % improvement in defecation frequency, a permanent stimulator was implanted. Primary outcome measure was defecation frequency during 3 weeks. Secondary endpoints were abdominal pain and Wexner score. To assess sustainability of treatment effect, a survival analysis was performed. Cross-sectional quality of life was assessed using the EQ-5D VAS score. RESULTS: Thirty girls, mean age 16 (range 10-20), were included. The mean defecation frequency increased from 5.9 (SD 6.5) in 21 days at baseline to 17.4 (SD 11.6) after 3 weeks of test treatment (p < 0.001). During test treatment, abdominal pain and Wexner score decreased from 3.6 to 1.5 and 18.6 to 8.5 (p < 0.001), respectively. Improvement of symptoms sustained during a median follow-up of 22.1 months (12.2-36.8) in 42.9 % of patients. On a scale from 0 to 100, quality of life was 7 points lower than the norm score (mean 70 vs. 77). CONCLUSION: SNM is a therapeutic option for children with chronic constipation not responding to intensive oral and/or laxative therapy, providing benefits that appear to be sustained over prolonged period of time.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sacro / Estreñimiento / Tratamiento Conservador Tipo de estudio: Observational_studies / Prognostic_studies Aspecto: Patient_preference Límite: Adolescent / Adult / Child / Female / Humans Idioma: En Revista: Int J Colorectal Dis Asunto de la revista: GASTROENTEROLOGIA Año: 2016 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sacro / Estreñimiento / Tratamiento Conservador Tipo de estudio: Observational_studies / Prognostic_studies Aspecto: Patient_preference Límite: Adolescent / Adult / Child / Female / Humans Idioma: En Revista: Int J Colorectal Dis Asunto de la revista: GASTROENTEROLOGIA Año: 2016 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Alemania