12 Months Results of Evaluation of Anal Sphincter Radiofrequency Remodeling.

BACKGROUND: The main doubt reducing enthusiasm for the radiofrequency remodeling technique (secca) was based on lack of physiological studies, which may explain the possible pathomechanism of improvement of symptoms.
AIM: The aim of this study was clinical physiological evaluation of the anorectal function prior and during 12 months follow-up after the secca procedure.
MATERIAL: 16 fecal incontinence (FI) patients (4 male and 12 female, mean age 59 ranged 41-78 years) have been enrolled into the study. The standard technique and secca device was used (Curon Medical, Freemont, CA USA). The following parameters were evaluated at baseline, 3, 6 and 12 months after the procedure: continence (CCF-FI, FI-SI scores), improvement (FI-QoL, patient diary, VAS), electromyography (EAS-superficial, IAS-needle), rectal electro- and thermosensitivity, barostat, anal manometry, morphology (endoanal ultrasound).
RESULTS: Comparing to baseline, 1, 3, 6 and 12 months average results were as follows: CCF-FI 12,1 – 10,4 – 9,1 – 9,3 – 6,8; FI-SI 36,9 – 38,6 – 34,9 – 35,2 – 30,8; compliance 5,6 – 5,6 – 4,0 – 4,2 – 4,0; manometry BAP 30,6 – 34,23 – 39,3 – 42 – 43, SAP 73,15 – 75,53 – 86,07 – 96,69 – 96,3; electrosensation 23 – 53 – 52 – 41 – 37, thermosensation 0,7 – 0,28 – 0,3 – 0,4 – 0,4, respectively. In FI-Qol scale significant improvement in 4 of 4 measures was observed, as well as IAS and EAS electromyography improvement.
CONCLUSIONS: Secca remodeling is safe and seems to be effective method of FI treatment. It reduces the frequency and severity of FI symptoms, and improves patient’s quality of life. This effect seems to be related to restored anorectal sensitivity and recto-anal coordination, however effect on IAS morphology and function is also detectable.


Session: Poster

Program Number: P152

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