A nomogram to predict risk factors of frequent defecation early after ileostomy reversal for rectal cancer patients

Abstract

Background: Defecation disorders after ileostomy reversal are among the most common complications for rectal cancer patients, and significantly diminish their quality of life. The aim of this study was to identify the risk factors associated with frequent defecation early after ileostomy reversal for rectal cancer patients.Methods: We retrospectively collected the data of rectal cancer patients who underwent ileostomy reversal from January 2018 to December 2019 at the Sixth Affiliated Hospital of Sun Yat-sen University. We divided patients into two groups: a no frequent defecation group (≤7 times/day) and a frequent defecation group (>7 times/day).Results: Of the 264 included patients, 59 patients (22.35%) had frequent defecation within 1 month after ileostomy closure and were defined as the frequent defecation group. There were no significant differences between the two groups in terms of gender, age, hypertension, and diabetes. Univariate and multivariate analyses showed that proctitis (P=0.04) and anastomotic stenosis (P=0.02) were independent risk factors for frequent defecation. Four factors, including proctitis, anastomotic stenosis, hypertension, and age were included to construct the nomogram. The consistency index of the nomogram was 0.949 and the area under the curve value was 0.623.Conclusions: For rectal cancer patients, proctitis and anastomotic stenosis were correlated with frequent defecation within 1 month after ileostomy closure. Surgeons should pay attention to the rectal examination before ileostomy reversal surgery.

Correlation between Pain and Anal Defecation Function in Postoperative Patients with Colorectal Cancer and Related Factors Affecting Patients' Prognosis

“…The mechanism of LARS is not fully understood, but it may be related to physiological and anatomical changes after colorectal resection; for example, after surgical treatment, there may be changes in colorectal volume and wall tension, which may lead to defecation dysfunction and LARS complications in patients [11,12]. Therefore, screening and pre-ventive measures should be taken to avoid the occurrence of LARS, and patients should be followed up and evaluated regularly for early detection and management of possible defecation dysfunction in order to improve the prognosis.…”