Sequential assessment of bowel function and anorectal physiology after anterior resection for cancer : a prospective cohort study
Abstract Aim The aim of this study was to investigate changes in bowel function and anorectal physiology (ARP) after anterior resection for colorectal cancer. Method Patients were recruited from November 2006 to September 2008. Cleveland Clinic Incontinence (CCI) scores and stool frequency were determined by patient questionnaires before surgery (t0) and at three (t3), six (t6), nine (t9) and 12 (t12) months after restoration of intestinal continuity. ARP measurements were recorded at T0, T3 and T12. Endoanal ultrasound was performed at T0 and T12. Results Eighty‐nine patients were included. CCI score increased postoperatively then normalized, whereas stool frequency did not change. Patients who had neoadjuvant radiotherapy or a lower anastomosis had increased incontinence and stool frequency in the postoperative period, whereas those with defunctioning stomas or open surgery had increased stool frequency alone. Maximum resting pressure, volume at first urge and maximum rectal tolerance were reduced throughout the postoperative period. Radiotherapy, lower anastomosis and defunctioning stoma (but not operative approach) altered manometric parameters postoperatively. Maximum rectal tolerance correlated with incontinence and first urge with stool frequency. The length of the anterior internal anal sphincter decreased postoperatively. Conclusions Incontinence recovers in the first year after anterior resection. Radiotherapy, lower anastomosis, defunctioning stoma and open surgery have a negative influence on bowel function. ARP may be useful if bowel dysfunction persists beyond 12 months..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:23 |
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| Enthalten in: |
Colorectal Disease - 23(2021), 9, Seite 2436-2446 |
| Beteiligte Personen: |
Pilkington, Sophie A. [VerfasserIn] |
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| BKL: |
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| Anmerkungen: |
Copyright © 2021 The Association of Coloproctology of Great Britain and Ireland |
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| Umfang: |
11 |
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| doi: |
10.1111/codi.15754 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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WLY003814106 |
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| 520 | |a Abstract Aim The aim of this study was to investigate changes in bowel function and anorectal physiology (ARP) after anterior resection for colorectal cancer. Method Patients were recruited from November 2006 to September 2008. Cleveland Clinic Incontinence (CCI) scores and stool frequency were determined by patient questionnaires before surgery (t0) and at three (t3), six (t6), nine (t9) and 12 (t12) months after restoration of intestinal continuity. ARP measurements were recorded at T0, T3 and T12. Endoanal ultrasound was performed at T0 and T12. Results Eighty‐nine patients were included. CCI score increased postoperatively then normalized, whereas stool frequency did not change. Patients who had neoadjuvant radiotherapy or a lower anastomosis had increased incontinence and stool frequency in the postoperative period, whereas those with defunctioning stomas or open surgery had increased stool frequency alone. Maximum resting pressure, volume at first urge and maximum rectal tolerance were reduced throughout the postoperative period. Radiotherapy, lower anastomosis and defunctioning stoma (but not operative approach) altered manometric parameters postoperatively. Maximum rectal tolerance correlated with incontinence and first urge with stool frequency. The length of the anterior internal anal sphincter decreased postoperatively. Conclusions Incontinence recovers in the first year after anterior resection. Radiotherapy, lower anastomosis, defunctioning stoma and open surgery have a negative influence on bowel function. ARP may be useful if bowel dysfunction persists beyond 12 months. | ||
| 700 | 1 | |a Bhome, Rahul |4 aut | |
| 700 | 1 | |a Gilbert, Sally |4 aut | |
| 700 | 1 | |a Harris, Scott |4 aut | |
| 700 | 1 | |a Richardson, Carl |4 aut | |
| 700 | 1 | |a Dudding, Thomas C. |4 aut | |
| 700 | 1 | |a Knight, John S. |4 aut | |
| 700 | 1 | |a King, Andrew T. |4 aut | |
| 700 | 1 | |a Mirnezami, Alex H. |4 aut | |
| 700 | 1 | |a Beck, Nicholas E. |4 aut | |
| 700 | 1 | |a Nichols, Paul H. |4 aut | |
| 700 | 1 | |a Nugent, Karen P. |4 aut | |
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