Effectiveness of Pelvic Floor Rehabilitation for Bowel Dysfunction After Intersphincteric Resection for Lower Rectal Cancer

Nishigori, Hideaki; Imamura, Masayuki; Kokado, Yujiro; Fujimoto, Keiichiro; Higashiyama, Hiroshi

doi:10.1007/s00268-018-4596-8

Cited by 15 publications

(32 citation statements)

References 26 publications

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“…42,60,72, 84,85,93,109,115,118,140,161–163,171,172,181,184,186,187,230–232,238, 240,256,260,308,314,320,329,342,344,355 In 13 studies (4.2%) 53, 58,65,108,111,142,143,145,159,316,337,343,351 non-validated questionnaires were used. Anal manometry was used in 126 studies (41.2%) 50,53,55,57,61,65,72,73,77,78,80,82,83, 85,86,91,92,95,96,…”

Section: Resultsmentioning

confidence: 99%

Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

et al. 2020

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Background Fecal incontinence is a disabling condition affecting up to 20% of women. Objective We investigated fecal incontinence assessment in both inflammatory bowel disease and non-inflammatory bowel disease patients to propose a diagnostic approach for inflammatory bowel disease trials. Methods We searched on Pubmed, Embase and Cochrane Library for all studies on adult inflammatory bowel disease and non-inflammatory bowel disease patients reporting data on fecal incontinence assessment from January 2009 to December 2019. Results In total, 328 studies were included; 306 studies enrolled non-inflammatory bowel disease patients and 22 studies enrolled inflammatory bowel disease patients. In non-inflammatory bowel disease trials the most used tools were the Wexner score, fecal incontinence quality of life questionnaire, Vaizey score and fecal incontinence severity index (in 187, 91, 62 and 33 studies). Anal manometry was adopted in 41.2% and endoanal ultrasonography in 34.0% of the studies. In 142 studies (46.4%) fecal incontinence evaluation was performed with a single instrument, while in 64 (20.9%) and 100 (32.7%) studies two or more instruments were used. In inflammatory bowel disease studies the Wexner score, Vaizey score and inflammatory bowel disease quality of life questionnaire were the most commonly adopted tools (in five (22.7%), five (22.7%) and four (18.2%) studies). Anal manometry and endoanal ultrasonography were performed in 45.4% and 18.2% of the studies. Conclusion Based on prior validation and experience, we propose to use the Wexner score as the first step for fecal incontinence assessment in inflammatory bowel disease trials. Anal manometry and/or endoanal ultrasonography should be taken into account in the case of positive questionnaires.

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Section: Resultsmentioning

confidence: 99%

Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

et al. 2020

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“…Besides, J-type pouch coloanal anastomosis may be superior to direct anastomosis in protecting anal function ( 36 ). When anal function changes after surgery, anal lavage ( 37 ), biofeedback therapy ( 38 ), and sacral nerve stimulation therapy ( 39 ) can be used to promote the recovery of anal function.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Clinical Efficacy and Safety Between da Vinci Robotic and Laparoscopic Intersphincteric Resection for Low Rectal Cancer: A Meta-Analysis

Zhang

et al. 2021

Front. Surg.

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Background and Aims: The intersphincteric resection (ISR) is beneficial for saving patients' anus to a large extent and restoring original bowel continuity. Laparoscopic ISR (L-ISR) has its drawbacks, such as two-dimensional images, low motion flexibility, and unstable lens. Recently, da Vinci robotic ISR (R-ISR) is increasingly used worldwide. The purpose of this article is to compare the feasibility, safety, oncological outcomes, and clinical efficacy of R-ISR vs. L-ISR for low rectal cancer.Methods: PubMed, EMBASE, Cochrane Library, and Web of Science were searched to identify comparative studies of R-ISR vs. L-ISR. Demographic, clinical, and outcome data were extracted. Mean difference (MD) and risk ratio (RR) with their corresponding confidence intervals (CIs) were calculated.Results: Five studies were included. In total, 510 patients were included, of whom 273 underwent R-ISR and 237 L-ISR. Compared with L-ISR, R-ISR has significantly lower estimated intraoperative blood loss (MD = −23.31, 95% CI [−41.98, −4.64], P = 0.01), longer operative time (MD = 51.77, 95% CI [25.68, 77.86], P = 0.0001), hospitalization days (MD = −1.52, 95% CI [−2.10, 0.94], P < 0.00001), and postoperative urinary complications (RR = 0.36, 95% CI [0.16, 0.82], P = 0.02).Conclusions: The potential benefits of R-ISR are considered as a safe and feasible alternative choice for the treatment of low rectal tumors.

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“…Most patients treated by anterior resections suffer diverse problems related to abnormal defecation, such as frequent bowel movements, urgency, sensation of incomplete evacuation, and fecal incontinence, together referred to as anterior resection syndrome (ARS)[ 2 ]. The social activities, quality of life, and mental status of patients with ARS are seriously compromised[ 2 ].The efficacy of rectal irrigation, biofeedback, pelvic floor rehabilitation, and sacral nerve stimulation in patients with ARS has been examined but the number of studies and the respective sample sizes are small[ 3 - 5 ]. Therefore, the factors impacting anorectal function and its underlying mechanism remain to be adequately investigated.…”

Section: Introductionmentioning

confidence: 99%

Anorectal dysfunction in patients with mid-low rectal cancer after surgery: A pilot study with three-dimensional high-resolution manometry

Pi¹,

Yi²,

Wang³

et al. 2022

WJCC

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BACKGROUND The quality of life in patients who develop low anterior resection syndrome (LARS) after surgery for mid-low rectal cancer is seriously impaired. The underlying pathophysiological mechanism of LARS has not been fully investigated. AIM To assess anorectal function of mid-low rectal cancer patients developing LARS perioperatively. METHODS Patients diagnosed with mid-low rectal cancer were included. The LARS score was used to evaluate defecation symptoms 3 and 6 mo after anterior resection or a stoma reversal procedure. Anorectal functions were assessed by three-dimensional high resolution anorectal manometry preoperatively and 3-6 mo after surgery. RESULTS The study population consisted of 24 patients. The total LARS score was decreased at 6 mo compared with 3 mo after surgery ( P < 0.05), but 58.3% (14/24) lasted as major LARS at 6 mo after surgery. The length of the high-pressure zone of the anal sphincter was significantly shorter, the mean resting pressure and maximal squeeze pressure of the anus were significantly lower than those before surgery in all patients ( P < 0.05), especially in the neoadjuvant therapy group after surgery ( n = 18). The focal pressure defects of the anal canal were detected in 70.8% of patients, and those patients had higher LARS scores at 3 mo postoperatively than those without focal pressure defects ( P < 0.05). Spastic peristaltic contractions from the new rectum to anus were detected in 45.8% of patients, which were associated with a higher LARS score at 3 mo postoperatively ( P < 0.05). CONCLUSION The LARS score decreases over time after surgery in the majority of patients with mid-low rectal cancer. Anorectal dysfunctions, especially focal pressure defects of the anal canal and spastic peristaltic contractions from the new rectum to anus postoperatively, might be the major pathophysiological mechanisms of LARS.

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Effectiveness of Pelvic Floor Rehabilitation for Bowel Dysfunction After Intersphincteric Resection for Lower Rectal Cancer

Cited by 15 publications

References 26 publications

Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

Tools for fecal incontinence assessment: lessons for inflammatory bowel disease trials based on a systematic review

Comparison of Clinical Efficacy and Safety Between da Vinci Robotic and Laparoscopic Intersphincteric Resection for Low Rectal Cancer: A Meta-Analysis

Anorectal dysfunction in patients with mid-low rectal cancer after surgery: A pilot study with three-dimensional high-resolution manometry

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