Predictive factors for compliance with transanal irrigation for the treatment of defecation disorders

作     者：Clémence Bildstein ChloéMelchior Guillaume Gourcerol Estelle Boueyre Valérie Bridoux Eric Vérin Anne-Marie Leroi 

作者机构：INSERM U1073Service de Physiologie DigestiveCHU Rouen INSERM U1073Service de Chirurgie DigestiveCHU Rouen EA 3830Pole 3RCHU RouenGroupe de Recherche sur le Handicap Ventilatoire INSERM CIC 0204 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2017年第23卷第11期

页      面：2029-2036页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Neurogenic bowel dysfunction Fecal incontinence Constipation Obstructed defecation Transanal irrigation 

摘      要：AIM To investigate compliance with transanal irrigation(TAI) one year after a training session and to identify predictive factors for *** The compliance of one hundred eight patients [87 women and 21 men; median age 55 years(range 18-83)] suffering from constipation or fecal incontinence(FI) was retrospectively assessed. The patients were trained in TAI over a four-year period at a single institution. They were classified as adopters if they continued using TAI for at least one year after beginning the treatment or as non-adopters if they stopped. Predictive factors of compliance with TAI were based on pretreatment assessments and trainingprogress. The outcomes of the entire cohort of patients who had been recruited for the TAI treatment were expressed in terms of *** Forty-six of the 108(43%) trained patients continued to use TAI one year after their training session. The patients with FI had the best results, with 54.5% remaining compliant with TAI. Only one-third of the patients who complained of slow transit constipation or obstructed defecation syndrome continued TAI. There was an overall discontinuation rate of 57%. The most common reason for discontinuing TAI was the lack of efficacy(41%). However, 36% of the patients who discontinued TAI gave reasons independent of the efficacy of the treatment such as technical problems(catheter expulsion, rectal balloon bursting, instilled water leakage or retention, pain during irrigation, anal bleeding, anal fissure) while 23% said that there were too many constraints. Of the patients who reported discontinuing TAI, the only predictive factor was the progress of the training(OR = 4.9, 1.3-18.9, P = 0.02).CONCLUSION The progress of the training session was the only factor that predicted patient compliance with TAI.