Rehabilitation of Fecal Incontinence After Sphincter-Saving Surgery for Rectal Cancer: Encouraging Results

Pucciani, Filippo; Ringressi, Maria Novella; Redditi, Stefania; Masi, A.; Giani, Iacopo

doi:10.1007/s10350-008-9312-6

Cited by 62 publications

(100 citation statements)

References 18 publications

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“…Three studies [8, 16, 17] included a group of patients with FI or ARS after a LAR and coloanal anastomosis while the remaining studies included patients not specifically suffering from FI after a LAR (Table 2). Most patients were treated with preoperative radiotherapy, and except for one study which included a higher anastomosis, the mean level of the anastomosis was below 5 cm from the dentate line [8].…”

Section: Resultsmentioning

confidence: 99%

“…Most patients were treated with preoperative radiotherapy, and except for one study which included a higher anastomosis, the mean level of the anastomosis was below 5 cm from the dentate line [8]. Functional outcome was mostly assessed by using the Wexner incontinence scale (WIS) [16, 17, 18], and anorectal evaluation by manometry was performed in three studies (Tables 3, 4) [8, 16, 17]. QoL was assessed in one study by using the fecal incontinence and quality of life (FIQL) questionnaire and the Short Form 36 questionnaire (SF-36) [18], and stool frequency was assessed in three studies [16, 18, 19].…”

Section: Resultsmentioning

confidence: 99%

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Pelvic Floor Rehabilitation to Improve Functional Outcome After a Low Anterior Resection: A Systematic Review

et al. 2014

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PurposeImpaired functional outcome is common after a low anterior resection (LAR). Pelvic floor rehabilitation (PFR) might improve functional outcome after a LAR. The aim of this systematic review is to evaluate the effectiveness of PFR in improving functional outcome.MethodsPubMed, Embase, and the Cochrane Library were searched using the terms fecal incontinence, colorectal neoplasm/surgery, LAR, rectal cancer, anterior resection syndrome, bowel habit, pelvic floor, training, therapy, physical therapy, rehabilitation and biofeedback. Of the 125 identified records, 5 articles were included.ResultsThe 5 included studies reported on 321 patients, of which 286 patients (89%) underwent pelvic floor training. Three studies included patients with anterior resection syndrome after a LAR while the remaining studies included a series of patients after a LAR. Functional outcome was mostly assessed by using the Wexner incontinence scale. Quality of life was assessed in one study, and in three studies, rectal manometry was performed. After PFR, the functional outcome was improved in four studies, as was the quality of life.ConclusionThis systematic review demonstrated that PFR is useful for improving the functional outcome after a LAR. The data are extracted from studies of limited quality, but the available evidence points to the effectiveness of the procedure.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Pelvic Floor Rehabilitation to Improve Functional Outcome After a Low Anterior Resection: A Systematic Review

et al. 2014

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“…Considering the bowel function following rectal surgery, relief from anal pain is important. Sphincter rehabilitation improves the bowel function; however, anal pain can prevent the anal sphincter movement [8,9] . Additionally, anal pain significantly decreases the patient's QOL.…”

Section: Discussionmentioning

confidence: 99%

Functional Outcomes of Patients Treated with Intensive Medications for Bowel and Pain Control for Low-Lying Rectal Cancer Who Received Preoperative Chemoradiotherapy

Beppu

Kimura²,

Doi³

et al. 2016

Dig Surg

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Purpose: The aim of this study was to assess the functional outcomes of patients treated with intensive medications for bowel and pain control for low-lying rectal cancer who received preoperative chemoradiotherapy (CRT). Methods: The inclusion criterion was sphincter-preserving surgery following CRT for T3 middle and low rectal cancer. Postoperative defecation control was conducted using calcium polycarbophil and loperamide, and anal pain control was conducted using oxycodone hydrochloride hydrate. The functional outcomes were determined by an annual questionnaire after stoma closure. Results: Of 64 patients evaluated, 33 were reconstructed using the double stapling technique (DST) and 31 were reconstructed using the intersphincteric resection (ISR) technique. The median Visual Analogue Scale at ISR was improved from 7 to 1.5 at 1 year after surgery. The median Wexner scores were 6.0, 6.0, 5.0 and 5.0 for DST and 14.5, 12.0, 10.0 and 8.0 for ISR for the first 4 years, respectively. The only independent predictor of a poor bowel function (Wexner score >10) according to a multivariate analyses was pelvic infection (OR 3.994, 95% CI 1.235-13.52, p = 0.021), while ISR was not a predictor. Conclusions: Anal pain following ISR can be controlled with oxycodone hydrochloride hydrate therapy. ISR is feasible following CRT for low-lying rectal cancer.

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“…The sessions lasted 1 month. The aim of volumetric rehabilitation was to increase the patient's ability to perceive the rectal distension induced by feces or flatus (''rectal sensation'') [13]. Volumetric rehabilitation involved twice daily administration of a tepid water enema.…”

Section: Multimodal Rehabilitationmentioning

confidence: 99%

Usefulness of psyllium in rehabilitation of obstructed defecation

2011

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Rehabilitation of Fecal Incontinence After Sphincter-Saving Surgery for Rectal Cancer: Encouraging Results

Cited by 62 publications

References 18 publications

Pelvic Floor Rehabilitation to Improve Functional Outcome After a Low Anterior Resection: A Systematic Review

Pelvic Floor Rehabilitation to Improve Functional Outcome After a Low Anterior Resection: A Systematic Review

Functional Outcomes of Patients Treated with Intensive Medications for Bowel and Pain Control for Low-Lying Rectal Cancer Who Received Preoperative Chemoradiotherapy

Usefulness of psyllium in rehabilitation of obstructed defecation

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