Radiofrequency anal sphincter remodeling (Secca Procedure) for the treatment of fecal incontinence: long term follow up

Poster presented at UEGW2010

METHODS: A total of 20 patients were enrolled in the study (14 females, 6 male) and underwent RFE. Attempts were made to contact all patients for follow-up, but only 18,14 and 10 were available 1,3 and 5 year respectively. The main causes of FI were either idiopathic or included obstetric injury, aging, and trauma from previous anorectal surgeries. These 20 patients had a mean age of 59.8 (range, 41-78) years. The mean duration of FI symp- toms was 95,7 months (range, 12–190) months. The mean treatment time was 34 (range, 20–40) minutes and the number of radiofrequency lesions in the anal canal varied from 50 to 78, with a mean of 64 . The radiofrequency procedure was well tolerated.There were 4 patients who experienced minor complications related to RFE, of whom 1 presented with minimal hematoma and bleeding within days after the procedure. Two patients complains of fever at 3-5 days after procedure, and the fourth patient revealed a small (2 mm) mucosal errosion two cm above dentral line on day 4 after treatment. All complications were resolved without incident.

RESULTS: The initial CCF-FI score was 12,1   at baseline, which improved to a mean score of 10.4 at 1 year, 9,1 at 3. years and 7,8 five  years  afrer treatment . Slide shows the scores from the initial visit compared with the  60-months follow-up.

CONCLUSION: In the long-term , prospective study Secca (Radiofrequency Anal Sphincter Remodeling) appeared safe and effective FI treatment. It reduces the frequency and severity of FI symptoms, and improves patient’s quality of life. Therapeutic effect of Secca is related to the improvement of sphincter function and restored anorectal sensitivity & recto-anal coordination.