Surgery for constipation: systematic review and practice recommendations: Results V: Sacral Nerve Stimulation

Area of Science:

• Gastroenterology
• Neurology
• Surgical Innovation

Background:

• Chronic constipation affects a significant portion of the adult population.
• Current treatment options for refractory chronic constipation are limited.
• Sacral nerve stimulation (SNS) is an emerging therapy for managing this condition.

Purpose of the Study:

• To evaluate the efficacy and safety of sacral nerve stimulation in adults diagnosed with chronic constipation.
• To synthesize existing evidence on the outcomes of SNS for chronic constipation.

Main Methods:

• Systematic review adhering to PRISMA 2016 guidelines.
• Inclusion of seven articles reporting outcomes for 375 patients.
• Assessment of benefits and harms using standardized methods.

Main Results:

• Pooled treatment success rates ranged from 57% to 87% for patients with permanent implants, with considerable study variation.
• Morbidity rates were reported between 13% and 34%, with device removal rates between 8% and 23%.
• Data on procedure length, length of stay, and patient selection were inconsistently reported; harm data were heterogeneous and imprecise.

Conclusions:

• The current evidence supporting sacral nerve stimulation for chronic constipation is based on low-quality studies.
• Subsequent robust trials emphasize the need for increased caution in the application of SNS.
• Further high-quality research is required to clarify patient selection and optimize treatment outcomes.