Comparison of patient-reported quality of life and functional outcomes following laparoscopic and transanal total mesorectal excision of rectal cancer

Ha, Ryun; Park, Sung Chan; Park, Boram; Sohn, Dae Kyung; Chang, Hee Jin; Oh, Jae Hwan

doi:10.4174/astr.2021.101.1.1

Cited by 11 publications

(6 citation statements)

References 30 publications

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“…LARS following rectal cancer surgery causes a change in bowel function in almost all patients [ 15 ]. Unfortunately, the cause of LARS, which disrupts a patient’s daily life, is still not fully understood [ 16 17 ]. Various causes have been considered, such as imbalance of bowel movement due to changes in the autonomic nervous system that controls bowel movements, excessive colonic contraction, and loss of defecation reservoir volume.…”

Section: Discussionmentioning

confidence: 99%

Analgesic effect of structured anal skin care for perianal dermatitis after low anterior resection in the rectal cancer patients: prospective, single-center, open-label, therapeutic confirmatory, randomized clinical trial

et al. 2022

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Purpose This prospective, single-center, open-label, therapeutic confirmatory, randomized clinical trial aimed to assess the alleviation of anal pain by applying structured anal skin care including skin protectants in rectal cancer patients with low anterior resection syndrome (LARS) combined with anal pain. Methods From December 2017 to May 2020, 42 patients with LARS (scores of ≥21) and anal pain (visual analogue scale [VAS] score of ≥3) were randomly assigned and observed for 4 weeks. The conventional treatment consisted of dietary management, sitz baths, prohibition of anal scrubbing, loperamide, and dioctahedral smectite. In the anal care group, cleanser, barrier cream, and barrier spray were applied to the anal skin after defecation following the conventional treatment. The primary outcome was analgesic effect on anal pain after 2 weeks of structured treatment (anal care group) or conventional (control group). The cutoff for analgesic effect was a decrease in the anal pain score (VAS score of ≥2 or ≥30% reduction). Results As a primary outcome, the analgesic effect was significantly higher in the anal care group (P = 0.034). The incontinence-associated dermatitis skin condition score was significantly improved in the anal care group than control group after 4 weeks (P = 0.023). There were no significant differences in LARS scores and quality of life scores between 2 groups. Conclusion Structured anal skin care has a significant analgesic effect in reducing anal pain and improving anal skin conditions in patients with LARS after rectal cancer surgery.

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Section: Discussionmentioning

confidence: 99%

Analgesic effect of structured anal skin care for perianal dermatitis after low anterior resection in the rectal cancer patients: prospective, single-center, open-label, therapeutic confirmatory, randomized clinical trial

et al. 2022

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“…Data regarding low anterior resection syndrome (LARS) are inconsistent with some studies showing higher rates of LARS after taTME and others showing similar rates of major LARS between the different operative approaches. [119][120][121] A large prospective national observational cohort study from the Netherlands (VANTAGE trial) aims to collect more nuanced comparative data on this topic with an anticipated enrollment of 1200 subjects. 122…”

Section: Compared To Laparoscopic Tme (L-tme) and Robotic Tme (R-tme)...mentioning

confidence: 99%

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Rectal Cancer 2023 Supplement

Langenfeld,

Davis,

Vogel

et al. 2023

Diseases of the Colon &Amp; Rectum

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he American Society of Colon and Rectal Surgeons (ASCRS) is dedicated to ensuring high-quality patient care by advancing the science, prevention, and management of disorders and diseases of the colon, rectum, and anus. The Clinical Practice Guidelines (CPG) Committee is composed of society members who are chosen because they have demonstrated expertise in the specialty of colon and rectal surgery. This committee was created to lead international efforts in defining quality care for conditions related to the colon, rectum, and anus and develop CPG based on the best available evidence.Although not proscriptive, these guidelines provide information on which decisions can be made and do not dictate a specific form of treatment. These guidelines are intended for the use of all practitioners, health care workers, and patients who desire information about the management of the conditions addressed by the topics covered in these guidelines. These guidelines should not be deemed inclusive of all proper methods of care nor exclusive of methods of care reasonably directed toward obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician considering all the circumstances presented by the individual patient. STATEMENT OF THE PROBLEMColorectal cancer is the third most common cancer and the third most common cause of cancer-related deaths in the United States. 1 Approximately 30% of these cancers will originate in the rectum, and the American Cancer Society estimated a total of 44,850 new rectal cancer diagnoses in the United States for 2022. 2 Adenocarcinoma of the rectum is inherently complex. Surgery for rectal cancer is technically challenging and is associated with major alterations in GI, urinary, and sexual functions and with decreased quality of life. [3][4][5] The treatment of rectal cancer is also rapidly evolving, with new data emerging on a regular basis.In 2020, the ASCRS published its most recent CPG for rectal cancer. 6 This was a comprehensive assessment covering a wide spectrum of topics. Since then, there have been Earn continuing medical education (CME) credit online at cme.lww. com. This activity has been approved for AMA PRA category 1 credit.Funding/Support: None reported.

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“…The standard of care for early rectal cancer is radical surgery, namely, total mesorectal excision (TME), which carries a high risk of postoperative morbidities and influences the patients’ quality of life [ 1 ]. Low anterior resection syndrome and stoma formation can negatively affect bowel function [ 2 3 ], along with various aspects of sexual dysfunction, urological difficulties, and psychological disturbances [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Short- and long-term outcomes of local excision with adjuvant radiotherapy in high-risk T1 rectal cancer patients

et al. 2022

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Purpose The standard of care for early rectal cancer is radical surgery; however, it carries high postoperative morbidity. This study aimed to assess the short-term and oncological outcomes of local excision and adjuvant radiotherapy in patients with high-risk pathological stage (p) T1 rectal cancer. Methods Fifty-five patients underwent local excision with adjuvant radiotherapy or radical resection for high-risk T1 rectal cancer. Patients with adenocarcinoma within 10 cm from the anal verge; pT1 with high-risk features (grade 3–4); a tumor size of ≥3 cm; a positive margin; a lymphovascular or perineural invasion; or a submucosal invasion depth of ≥SM2 were included. Results The rates of postoperative complications and stoma formation were higher in the radical surgery group (P = 0.021 and P = 0.003, respectively). No significant differences were observed in the overall survival and disease-free survival (DFS) between the 2 groups (P = 0.301 and P = 0.076, respectively). Vascular invasion was a significantly poor prognostic factor for DFS (P = 0.033). The presence of 3 or more high-risk features was associated with a poor DFS (P = 0.002). Conclusion Local excision with adjuvant radiotherapy significantly reduces the risk of complications and stoma formation. It is also an alternative option for patients with fewer than 3 high-risk features.

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Comparison of patient-reported quality of life and functional outcomes following laparoscopic and transanal total mesorectal excision of rectal cancer

Cited by 11 publications

References 30 publications

Analgesic effect of structured anal skin care for perianal dermatitis after low anterior resection in the rectal cancer patients: prospective, single-center, open-label, therapeutic confirmatory, randomized clinical trial

Analgesic effect of structured anal skin care for perianal dermatitis after low anterior resection in the rectal cancer patients: prospective, single-center, open-label, therapeutic confirmatory, randomized clinical trial

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Rectal Cancer 2023 Supplement

Short- and long-term outcomes of local excision with adjuvant radiotherapy in high-risk T1 rectal cancer patients

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