Effectiveness of Biofeedback Therapy in the Treatment of Anterior Resection Syndrome After Rectal Cancer Surgery

Abstract

Biofeedback therapy produced significant clinical benefits for patients with severe fecal incontinence and may be an effective treatment for patients with anterior resection syndrome after surgery for rectal cancer.

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

“…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].…”

“…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].…”

“…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]. In two studies, a cohort of patients was assessed regarding functional outcome before and after a rehabilitation program [16, 17], and two other studies compared groups of patients with and without PFR [18, 19].…”

Effects of Radiation Therapy for Rectal Cancer on Anorectal Function

“…Interestingly, satisfaction scores were significantly higher after biofeedback therapy in patients treated with surgery plus radiotherapy than in patients treated by surgery alone. Both of these groups had significant improvements in fecal incontinence score and number of bowel movements, but only the radiotherapy group had statistically significant improvement in anorectal manometry parameters [47].…”

“…However, because functional outcomes tend to improve overtime, even in the absence of biofeedback, the symptoms of anterior resection syndrome usually improve gradually or even disappear during the first 1-2 years after resection. Therefore, waiting for improvement of symptoms during this period of adaptation is one of the most commonly used strategies for postradiation fecal incontinence [47].…”