A Cross-Sectional Review of Reporting Variation in Postoperative Bowel Dysfunction After Rectal Cancer Surgery

Chapman, Stephen J.; Bolton, William; Corrigan, Neil; Young, Neville; Jayne, David

doi:10.1097/dcr.0000000000000649

Cited by 28 publications

(26 citation statements)

References 24 publications

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“…However, at the time of the functional assessment in this study, this scoring system had not been available yet. A recent cross-sectional review of 234 studies between 2004 and 2015 proved the most frequently used instrument to be the Wexner Score, although the LARS Score is gaining popularity [4].…”

Section: Discussionmentioning

confidence: 99%

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Fecal incontinence after total mesorectal excision for rectal cancer—impact of potential risk factors and pelvic intraoperative neuromonitoring

et al. 2020

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Background: Fecal incontinence frequently occurs after total mesorectal excision for rectal cancer. This prospective study analyzed predictive factors and the impact of pelvic intraoperative neuromonitoring at different follow-up intervals. Methods: Fifty-two patients were included undergoing total mesorectal excision for rectal cancer, and 29 under control of pelvic intraoperative neuromonitoring. Fecal incontinence was assessed using the Wexner Score at 3 and 6 months after stoma closure (follow-ups 1 and 2) as well as 1 and 2 years after surgery (follow-ups 3 and 4). Risk factors were identified by means of logistic regression. Results: New onset of fecal incontinence was significantly lower in the neuromonitoring group at each follow-up (follow-up 1: 2 of 29 patients (7%) vs. 8 of 23 (35%), (p = 0.014); follow-up 2: 3 of 29 (10%) vs. 9 of 23 (39%), (p = 0.017); follow-up 3: 5 of 29 (17%) vs. 11 of 23 (48%), p = 0.019; follow-up 4: 6 of 28 (21%) vs. 11 of 22 (50%), p = 0.035). Non-performance of neuromonitoring was found to be an independent predictor for fecal incontinence throughout the survey. Neoadjuvant chemoradiotherapy was an independent predictor in the further course 1 and 2 years after surgery. Conclusions: Performance of pelvic intraoperative neuromonitoring is associated with significantly lower rates of fecal incontinence. Neoadjuvant chemoradiotherapy was found to have negative late effects. This became evident 1 year after surgery.

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Section: Discussionmentioning

confidence: 99%

“…This resulted in substantial variations in the reporting of the abovementioned symptoms. The most frequently used instrument is the validated Wexner Score focusing on FI [4].…”

Section: Introductionmentioning

confidence: 99%

Fecal incontinence after total mesorectal excision for rectal cancer—impact of potential risk factors and pelvic intraoperative neuromonitoring

et al. 2020

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“…Although pragmatic, this definition can incorporate a vast array of symptoms from faecal incontinence and urgency to evacuation difficulties. Consequent heterogeneity in reporting makes it impossible to accurately identify the prevalence of LARS . Development of a validated patient‐reported outcome measure, the LARS score, has improved the standardization of reporting and prevalence of LARS using this tool is reported to be 41% (95% CI 34%–48%) .…”

Section: Introductionmentioning

confidence: 99%

International consensus definition of low anterior resection syndrome

et al. 2020

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Aim Low anterior resection syndrome (LARS) is pragmatically defined as disordered bowel function after rectal resection leading to a detriment in quality of life. This broad characterization does not allow for precise estimates of prevalence. The LARS score was designed as a simple tool for clinical evaluation of LARS. Although the LARS score has good clinical utility, it may not capture all important aspects that patients may experience. The aim of this collaboration was to develop an international consensus definition of LARS that encompasses all aspects of the condition and is informed by all stakeholders. Method This international patient–provider initiative used an online Delphi survey, regional patient consultation meetings, and an international consensus meeting. Three expert groups participated: patients, surgeons and other health professionals from five regions (Australasia, Denmark, Spain, Great Britain and Ireland, and North America) and in three languages (English, Spanish, and Danish). The primary outcome measured was the priorities for the definition of LARS. Results Three hundred twenty‐five participants (156 patients) registered. The response rates for successive rounds of the Delphi survey were 86%, 96% and 99%. Eighteen priorities emerged from the Delphi survey. Patient consultation and consensus meetings refined these priorities to eight symptoms and eight consequences that capture essential aspects of the syndrome. Sampling bias may have been present, in particular, in the patient panel because social media was used extensively in recruitment. There was also dominance of the surgical panel at the final consensus meeting despite attempts to mitigate this. Conclusion This is the first definition of LARS developed with direct input from a large international patient panel. The involvement of patients in all phases has ensured that the definition presented encompasses the vital aspects of the patient experience of LARS. The novel separation of symptoms and consequences may enable greater sensitivity to detect changes in LARS over time and with intervention.

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“…Whilst pragmatic, this definition can incorporate a vast array of symptoms from faecal incontinence and urgency, to evacuation difficulties. Consequent heterogeneity in reporting makes it impossible to accurately identify the prevalence of LARS . Development of a validated patient‐reported outcome measure, the LARS score, has improved standardization of reporting .…”

Section: Introductionmentioning

confidence: 99%

“…Consequent heterogeneity in reporting makes it impossible to accurately identify the prevalence of LARS. [9][10][11] Development of a validated patient-reported outcome measure, the LARS score, has improved standardization of reporting. 12 Prevalence of LARS using this tool is reported to be 41% (95% confidence interval 34-48%).…”

Section: Introductionmentioning

confidence: 99%

International consensus definition of low anterior resection syndrome

Keane

Fearnhead

Bordeianou

et al. 2020

ANZ Journal of Surgery

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Background Low anterior resection syndrome (LARS) is pragmatically defined as disordered bowel function after rectal resection leading to a detriment in quality of life. This broad characterization does not allow for precise estimates of prevalence. The LARS score was designed as a simple tool for clinical evaluation of LARS. Although the LARS score has good clinical utility, it may not capture all important aspects that patients may experience. The aim of this collaboration was to develop an international consensus definition of LARS that encompasses all aspects of the condition and is informed by all stakeholders. Methods This international patient‐provider initiative used an online Delphi survey, regional patient consultation meetings and an international consensus meeting. Three expert groups participated: patients, surgeons and other health professionals from five regions (Australasia, Denmark, Spain, Great Britain and Ireland, and North America) and in three languages (English, Spanish and Danish). The primary outcome measured was the priorities for the definition of LARS. Results Three hundred and twenty‐five participants (156 patients) registered. The response rates for successive rounds of the Delphi survey were 86%, 96% and 99%. Eighteen priorities emerged from the Delphi survey. Patient consultation and consensus meetings refined these priorities to eight symptoms and eight consequences that capture essential aspects of the syndrome. Sampling bias may have been present, in particular, in the patient panel because social media was used extensively in recruitment. There was also dominance of the surgical panel at the final consensus meeting despite attempts to mitigate this. Conclusions This is the first definition of LARS developed with direct input from a large international patient panel. The involvement of patients in all phases has ensured that the definition presented encompasses the vital aspects of the patient experience of LARS. The novel separation of symptoms and consequences may enable greater sensitivity to detect changes in LARS over time and with intervention.

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A Cross-Sectional Review of Reporting Variation in Postoperative Bowel Dysfunction After Rectal Cancer Surgery

Cited by 28 publications

References 24 publications

Fecal incontinence after total mesorectal excision for rectal cancer—impact of potential risk factors and pelvic intraoperative neuromonitoring

Fecal incontinence after total mesorectal excision for rectal cancer—impact of potential risk factors and pelvic intraoperative neuromonitoring

International consensus definition of low anterior resection syndrome

International consensus definition of low anterior resection syndrome

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