The Long-term Effectiveness of Sacral Neuromodulation in Treating Low Anterior Resection Syndrome: A Single Center Experience

Abstract

Abstract Background Sacral neuromodulation (SNM) has emerged as an effective treatment option for patients with fecal incontinence. The efficacy of SNM in the treatment of low anterior resection syndrome (LARS) following rectal cancer surgery is encouraging. The aim of this study is to review the long-term outcomes of patients treated with SNM for LARS. Methods A review of a prospectively maintained database of consecutive SNM procedures for LARS between June 2017 and June 2020 was conducted. Bowel habits diaries, the Cleveland Clinic Florida-Fecal Incontinence score (CCF-FIS), the Fecal Incontinence Quality of Life Scale (FIQoL), and the LARS score were evaluated at baseline, three months, and twenty-four months after definitive SNM implantation. Results The study included 14 patients; 11 of them were males, and the mean age was 59.2 (±10.2). Thirteen patients underwent permanent implantation of the SNM device. The mean score of FI episodes were reduced from 16 to 4 (p < 0.001) and the mean CCF-FIS dropped from 15.2 to 6.5 (p < 0.001). All patients showed a substantial increase in their FIQoL scale (p < 0.001). Additionally, there was a significant amelioration in the LARS score (36.7 to 17.3, p < 0.001) and all symptoms of LARS except incontinence of liquid stool (p = 0.97). Conclusions SNM improves bowel dysfunction and quality of life in patients with LARS following rectal cancer surgery and maintains its effectiveness over time