BACKGROUND: Controlled delivery of radio frequent energy (Secca) has been suggested as treatment for faecal incontinence (FI). OBJECTIVE: The objective of the study is to evaluate clinical response and sustainability of Secca for FI. DESIGN: This is a prospective cohort study. PATIENTS: This study involved patients who had failed full conservative management for FI. INTERVENTIONS: This study was performed between 2005 and 2010. MAIN OUTCOME MEASURES: FI was scored using the Vaizey score (VS). A clinically significant response to Secca was defined as ≥50 % reduction in incontinence score. Impact of FI on quality of life (QOL) was measured using the FIQL. Data was obtained at baseline, at 6 months and at 1 and 3 years. Anal endosonography and anal manometry were performed at 3 months and compared to baseline. RESULTS: Thirty-one patients received Secca. During follow-up, 5/31 (16 %), 3/31 (10 %) and 2/31 (6 %) of patients maintained a clinically significant response after the Secca procedure. Mean VS of all patients was 18 (SD 3), 14 (SD 4), 14 (SD 4) and 15 (SD 4), at baseline, 6 months and 1 and 3 years. No increases in anorectal pressures or improvements in rectal compliance were found. Coping improved between baseline and t = 6 months. No predictive factors for success were found. LIMITATIONS: This is a non-randomised study design. CONCLUSION: This prospective non-randomised trial showed disappointing outcomes of the Secca procedure for the treatment of FI. The far minority of patients reported a clinically significant response of seemingly temporary nature. Secca might be valuable in combination with other interventions for FI, but this should be tested in strictly controlled randomised trials.
BACKGROUND: Controlled delivery of radio frequent energy (Secca) has been suggested as treatment for faecal incontinence (FI). OBJECTIVE: The objective of the study is to evaluate clinical response and sustainability of Secca for FI. DESIGN: This is a prospective cohort study. PATIENTS: This study involved patients who had failed full conservative management for FI. INTERVENTIONS: This study was performed between 2005 and 2010. MAIN OUTCOME MEASURES: FI was scored using the Vaizey score (VS). A clinically significant response to Secca was defined as ≥50 % reduction in incontinence score. Impact of FI on quality of life (QOL) was measured using the FIQL. Data was obtained at baseline, at 6 months and at 1 and 3 years. Anal endosonography and anal manometry were performed at 3 months and compared to baseline. RESULTS: Thirty-one patients received Secca. During follow-up, 5/31 (16 %), 3/31 (10 %) and 2/31 (6 %) of patients maintained a clinically significant response after the Secca procedure. Mean VS of all patients was 18 (SD 3), 14 (SD 4), 14 (SD 4) and 15 (SD 4), at baseline, 6 months and 1 and 3 years. No increases in anorectal pressures or improvements in rectal compliance were found. Coping improved between baseline and t = 6 months. No predictive factors for success were found. LIMITATIONS: This is a non-randomised study design. CONCLUSION: This prospective non-randomised trial showed disappointing outcomes of the Secca procedure for the treatment of FI. The far minority of patients reported a clinically significant response of seemingly temporary nature. Secca might be valuable in combination with other interventions for FI, but this should be tested in strictly controlled randomised trials.
Authors: Takeshi Takahashi; Sandra Garcia-Osogobio; Miguel Angel Valdovinos; Wilbert Mass; Ramiro Jimenez; Luis Alfonso Jauregui; Juan Bobadilla; Carlos Belmonte; Peter S Edelstein; David S Utley Journal: Dis Colon Rectum Date: 2002-07 Impact factor: 4.585
Authors: M Frascio; F Mandolfino; M Imperatore; C Stabilini; R Fornaro; E Gianetta; S D Wexner Journal: Colorectal Dis Date: 2014-03 Impact factor: 3.788