Persisting anorectal dysfunction after rectal cancer surgery. (November 2013)

• Record Type: Journal Article
• Authors: Maris, A.; Penninckx, F.; Devreese, A. M.; Staes, F.; Moons, P.; Van, E.; Haustermans, K.; D'Hoore, A.
• Is Part Of: Colorectal disease. Volume 15:Number 11(2013)
• Page Start: e672
• Page End: e679
• Publication Date: 2013-11
• Subjects: Colon (Anatomy) -- Diseases -- Periodicals; Rectum -- Diseases -- Periodicals; 616.34
• DOI: 10.1111/codi.12291
• Languages: English
• ISSNs: 1462-8910

Abstract

<abstract abstract-type="main" id="codi12291-abs-0001"> <title>Abstract</title> <sec id="codi12291-sec-0001" sec-type="section"> <title>Aim</title> <p>Sphincter‐saving rectal cancer management affects anorectal function. This study evaluated persisting anorectal dysfunction and its impact on patients' well‐being.</p> </sec> <sec id="codi12291-sec-0002" sec-type="section"> <title>Method</title> <p>Seventy‐nine patients with a follow‐up of 12–37 (median 22) months and 79 age‐ and sex‐matched control subjects completed questionnaires.</p> </sec> <sec id="codi12291-sec-0003" sec-type="section"> <title>Results</title> <p>The median number of diurnal bowel movements was three in patients and one in controls (<italic>P </italic><<italic> </italic>0.0001). Nocturnal defaecation occurred in 53% of patients. The median Vaizey score was 8 in patients and 4 in controls (<italic>P </italic><<italic> </italic>0.0001). Urgency without incontinence was reported by 47% of patients and 49% of controls (<italic>P </italic>=<italic> </italic>0.873), soiling by 28% of patients and 3% of controls (<italic>P </italic><<italic> </italic>0.0001), incontinence for flatus by 73% of patients and 49% of controls (<italic>P </italic>=<italic> </italic>0.0019), and incontinence for solid stools by 16% of patients and 4% of controls (<italic>P </italic>=<italic> </italic>0.0153). Incontinence of liquid stools occurred in 17 of 20 patients and in one of five controls who had liquid stools (<italic>P </italic>=<italic> </italic>0.0123). Incontinence for gas, liquid or solid stool occurred once or more weekly in 47%, 19% and 6% of patients respectively. Evacuation difficulties were reported by 98% of patients, but also by 77% of controls. Neoadjuvant radio(chemo)therapy adversely affected defaecation frequency and continence. Incontinence was associated with severe discomfort in 50% of patients, severe anxiety in 40% and severe embarrassment in 48%.</p> </sec> <sec id="codi12291-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Anorectal dysfunction is a frequent problem after management of rectal cancer with an impact on the well‐being of patients.</p> </sec> </abstract>