Treatment options to improve anorectal function following rectal resection: a systematic review

Abstract

Conservative therapies such as pelvic floor re-education and colonic irrigation can improve anorectal function. SNS might be an effective solution in selected patients. However, methodologically qualitative studies are limited and randomized controlled trials are needed to draw evidence-based conclusions.

Pelvic floor muscle training for bowel dysfunction following colorectal cancer surgery: A systematic review

“…Although the review reported beneficial effects of conservative therapies on anorectal function after rectal resection, the papers reviewed were of limited methodological quality with heterogeneous patient populations, such as patients with rectal cancer, cervical cancer, and undefined pathology. 20 The findings of this systematic review on specific bowel cancer populations are consistent with the 5 th International Consultation on Incontinence, which recommends PFMT as an early intervention in the treatment of fecal incontinence in general adult populations. 17 The results of the present study demonstrate a modest reduction in stool frequency and incontinence episodes measured by patient bowel diary or patient report after PFMT.…”

“…The findings in this review are in line with a previous systematic review on treatment options for improving anorectal function after rectal surgery for patients with or without cancer . The previous review examined fifteen studies, which included heterogeneous treatment options, such as pelvic floor re‐education (seven out of fifteen studies), colonic irrigation, and sacral nerve stimulation.…”

“…Our systematic review adds to a previous systematic review in several ways: the inclusion of two additional studies published in 2011, the inclusion of colon as well as rectal cancer populations, and a focus on PFMT as the primary intervnetion. In contrast to the prior review, we excluded case studies due to the high potential for bias in this study design and studies which had less than 50% of participants with CRC in order to maintain the homogeneity of the target population.…”

“…The findings in this review are in line with a previous systematic review on treatment options for improving anorectal function after rectal surgery for patients with or without cancer. 20 The previous review examined fifteen studies, which included heterogeneous treatment options, such as pelvic floor re-education (seven out of fifteen studies), colonic irrigation, and sacral nerve stimulation. Although the review reported beneficial effects of conservative therapies on anorectal function after rectal resection, the papers reviewed were of limited methodological quality with heterogeneous patient populations, such as patients with rectal cancer, cervical cancer, and undefined pathology.…”

Development and external validation of a nomogram and online tool to predict bowel dysfunction following restorative rectal cancer resection: the POLARS score

“…Therefore, these side effects of treatment are frequently missed or overlooked 13. Encouragingly, recent studies suggest that incremental improvements in bowel dysfunction can be achieved14 and the results of the optimising radiotherapy bowel injury therapy (ORBIT) study demonstrate that a detailed clinical algorithm of targeted treatment strategies can improve radiotherapy-induced symptoms 15…”