Anorectal Function and Quality of Life after Transrectal Rigid-Hybrid Natural Orifice Translumenal Endoscopic Sigmoidectomy

Steinemann, Daniel C.; Zerz, Andreas; Germann, Sara; Lamm, Sebastian H.

doi:10.1016/j.jamcollsurg.2016.04.002

Cited by 7 publications

(20 citation statements)

References 31 publications

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“…There is limited literature about the impact on quality of life and anorectal function after the performance of a TaTME procedure. Similar results to ours were obtained in a group of 25 patients undergoing transanal sigmoidectomy, even with manometric data showing that they do not experience variations in the anorectal function or that these are transient and do recover 19 . There is a study assessing the quality of life of a group of 30 patients undergoing TaTME, where the same questionnaires used in this work were applied twice: at one month and at 6 months postoperatively 20 .…”

Section: Discussionsupporting

confidence: 90%

Functional impairment and quality of life after rectal cancer surgery

Mora¹,

Zarate²,

Serra‐Aracil³

et al. 2019

CIRUE

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Background:The gold standard of rectal surgery remains total mesorrectal excision (ETM) in which laparoscopy is applied for its advantages. The attempt to avoid 17% conversion rate implies that transanal techniques are applied. Transanal ETM (TaETM) is performed by experimental groups with good oncological and morbimortality results. Objective: This study determines the quality of life and the anorectal function of these patients. Method: Observational study of two cohorts comparing patients undergoing rectal tumor surgery using TaETM or conventional ETM after a minimum of six months of intestinal transit reconstruction. EORTC-30, EORTC-29 quality of life questionnaires and the anorectal function assessment questionnaire (LARS score) are applied. General variables are also collected. Results: 31 patients between 2011 and 2014: 15 ETM group and 16 TaETM. We do not find statistically significant differences in quality of life questionnaires or in anorectal function. Statistically significant general variables: longer surgical time in the TaETM group. Nosocomial infection and minor suture failure in the TaETM group. Conclusion: The performance of TaETM achieves the same results in terms of quality of life and anorectal function as conventional ETM.

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Section: Discussionsupporting

confidence: 90%

Functional impairment and quality of life after rectal cancer surgery

Mora¹,

Zarate²,

Serra‐Aracil³

et al. 2019

CIRUE

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“…Out of 23 studies, 20 provided postoperative HRQoL measurements after diverticular resection ( Table 2 ), 15 – 30 , 32 , 34 , 36 , 37 10 thereof with an additional preoperative questionnaire. 15 – 18 , 20 , 22 , 23 , 25 , 29 , 36 and 2 with a conservatively treated control group. 16 , 17 Among them, HRQoL was recorded in 11 studies after elective surgery.…”

Section: Resultsmentioning

confidence: 99%

“…However, functional outcomes did not change in two studies. In the prospective cohort study by Steinemann et al 20 which used an innovative surgical-endoscopic hybrid approach, no postoperative change in stool consistency, nocturnal defaecation, stool evacuation and incontinence was reported, as compared to preoperative symptoms. Similarly, in another prospective cohort D Segna, PJ Jaklin et al…”

Section: Postoperative Functional Disordersmentioning

confidence: 96%

“…20,23,28,29,31,33,35 Furthermore, functional disorders after elective diverticular surgery were recorded in seven studies. 15,20,23,29,32,33,37 The most frequently reported functional complaints were defaecation disorders in six studies such as abnormal defaecation, faecal incontinence, difficult or incomplete evacuation, or nocturnal defaecation. [18][19][20]23,24,26 Thereof, two studies provided longitudinal comparisons with a positive impact of both elective laparoscopic and open sigmoid resection on abnormal defaecation in 77.1% in the retrospective cohort study by van de Wall et al, 23 while the prospective cohort study by Steinemann et al 20 assessing the impact of elective transrectal rigid hybrid natural orifice transluminal endoscopic sigmoidectomy showed no significant improvement in nocturnal defaecation, difficult or incomplete evacuation.…”

Section: Postoperative Functional Disordersmentioning

confidence: 99%

“…Different measures for incontinence were applied and incontinence rates ranged from 5.4% involuntary stool loss once a week to 11.4% once a month, 19 10%, 24 or 24.8% 26 in other studies. Only in the prospective cohort study by Steinemann et al, 20 St. Marks incontinence score was repeatedly assessed preoperatively and at 6 and 12 months and no significant dynamics upon surgery was observed. Furthermore, faecal urgency was a common postoperative finding among 4.25% of patients in the retrospective cohort study by Turoldo et al, 18 while Magdeburg et al 19 reported urgency in 3.4% of patients more than once a week and in 12.5% more than once a month.…”

Section: Postoperative Functional Disordersmentioning

confidence: 99%

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Health-related quality of life and functional disorders after diverticular surgery

Segna

Jaklin

Schnüriger

et al. 2021

Therap Adv Gastroenterol

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Diverticulosis and diverticulitis are leading indications for colorectal surgery in Western countries. Abdominal pain, functional disorders, and low health-related quality of life (HRQoL) can limit the outcome of abdominal surgery even in the absence of complications. Therefore, we aimed to review current evidence on postoperative long-term outcomes including HRQoL, functional disorders, abdominal pain, and patients’ satisfaction after diverticular surgery for diverticulosis/diverticulitis. We performed a PubMed database search (inception: 17 December 2020). Identified publications were screened and outcome parameters extracted. In summary, HRQoL increased after diverticular surgery in 9 out of 10 longitudinal cohort studies. Similarly, patients’ satisfaction with treatment and their choice to undergo surgery was commonly reported as high or very good, as reported in eight studies. In a randomized control trial and retrospective cohort, elective diverticular surgery was superior to conservative treatment regarding HRQoL. In cross-sectional analyses, chronic abdominal pain and functional disorders including defaecation disorders or diarrhoea/obstipation were found in a relevant fraction of patients. Incontinence ranged from 5% to 25% with insufficient data for comparison before and after surgery. However, functional disorders did not result in decreased HRQoL in most studies, and no increase in functional disorders was observed after elective diverticular surgery in longitudinal analyses. We conclude that HRQoL among operated patients with diverticular disease improved in most studies after surgery. Functional disorders and postoperative abdominal pain can be present after elective diverticular surgery; however, no increase in functional disorders was observed in longitudinal studies. Functional disorders after diverticular surgery need to be carefully discussed with the patient before surgery and a careful clinical assessment before surgery including incontinence scoring should be considered.

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