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Representatives from the centers experienced in sacral neuromodulation for the treatment of bowel dysfunctions met in
order to define the current clinical practice in Italy and to produce a consensus statement regarding therapy indications
and its management. Fifty Italian colon proctologists were asked to complete a questionnaire concerning their clinical practice
in sacral neuromodulation (290 questions, grouped within 4 broad areas). Physicians expressed their opinion by completing
the questionnaire, assigning to each statement their level of agreement according to the five-point Likert scale; the data were
analyzed by attributing to each expert?s answers a weight proportional to the degree of experience. During a following meeting,
the critical aspects of the therapy were re-examined and physicians further discussed with the goal of reaching an agreement
on controversial topics referencing and comparing to the available literature. Patient selection criteria, etiology, diagnostic
investigations, test procedures and implantation, follow-up and evaluation of results have been reviewed. The aim was to achieve
an algorithm for patient management, showing the place of SNM in bowel dysfunctions. The approach in case of treatment
failure was also discussed. Analysis of the data collected reveals substantial consensus at the national level concerning all the
main points with regard to the therapy. The recommendations expressed in this article can be considered as national guidelines
and taken into account by the principal international implantation centers.
Biography
Ezio Falletto has completed his PhD in 1988 at the age of 25 years from University of Turin School of Medicine and Postdoctoral studies in General Surgery from
Stanford University of Turin School of Medicine. He attended a Postgraduate Teaching Course in Coloproctology at St. Mark?s Hospital of London, UK, From
January to April 1993. He is a Colorectal Surgeon of the Department of Surgery of Cittą della Scienza e della Salute of Turin, Italy. He has published more than 10
papers in reputed international journals and serving as an Associate Editor for Techniques in Coloproctology. He is an Editorial Board Member of World Journal of
Gastroenterology and Reviewer of many reputed international journals (British Journal of Surgery, Neurogastroenterology and Motility, Archives of Surgery, BMC
Gatroenterology, etc).
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