Exploring bowel dysfunction of patients following colorectal surgery: A cohort study

Abstract

Aims and objectives To examine changes in patients’ bowel function and to compare patients’ outcome among different operation and treatment after rectal resection. Background Anal‐preserving surgery is the trend of treatment of colorectal cancer and bowel function after surgery needs to be concerned. Design Prospective cohort study. Methods A total of 38 patients with convenience sampling were recruited from a teaching hospital. The low anterior resection syndrome (LARS) score was used to assess bowel function disturbances before discharge and at 1 week, 1 month and 3 months after discharge. We followed the STROBE checklist to ensure rigour in our study. Results Approximately half of the patients experienced major LARS, including daily stool frequency of more than seven times and stool clustering at least once a week. The LARS scores observed at 1 month after discharge were significantly higher than those observed before discharge. Patients who received intersphincteric resection had higher LARS scores compared with those who received other surgeries. Furthermore, patients who underwent concurrent chemoradiotherapy, operation (OP) and chemotherapy had the highest LARS scores compared with those who underwent only an OP. Conclusion The patients experienced varied intestinal dysfunction after surgery based on their treatment plan and surgical method. Nurses should provide individualised health education for these patients. Relevance to clinical practice A health education booklet is recommended to educate patients about LARS symptoms and the techniques to adapt in their daily lives after surgery.

Robotic rectal resection preserves anorectal function: Systematic review and meta‐analysis

“…Applying the LARS score, several risk factors for impairment of anorectal function following TME have been identified by various studies. The strongest impact on LARS is for location of anastomosis, with greatest adverse effects for tumours in the lower third of the rectum 16,17,25,36‐42 and perioperative radiation 16,17,25,27,30,31,36,38,40,42‐47 . In our analysis, the rates for perioperative radiation varied from 44.1% for OTME to 52.5% for TaTME.…”

“…The strongest impact on LARS is for location of anastomosis, with greatest adverse effects for tumours in the lower third of the rectum 16,17,25,[36][37][38][39][40][41][42] and perioperative radiation. 16,17,25,27,30,31,36,38,40,[42][43][44][45][46][47] In our analysis, the rates for perioperative radiation varied from 44.1% for OTME to 52.5% for TaTME. In particular, RoTME revealed significantly superior functional results in the continuous and categorical analysis and ranked midfield in terms of the proportion of irradiated patients.…”

Spanish Translation, Face Validity, and Reliability of the ICIQ-B Questionnaire with Colorectal Cancer Patients

“…2 Colorectal cancer may produce many bowel symptoms which have a negative impact on functioning and quality of life (QoL). [3][4][5] Prior to treatments, patients usually report changes in bowel habits, such as the frequency of defecation, the consistency and shape of the stool, and difficulty in evacuation; all of these symptoms are usually called constipation or diarrhea. 5 New surgical techniques for colorectal cancer have been proposed to prevent ostomy and maintain continence.…”

The Effect of Pelvic Floor Rehabilitation on Lower Anterior Resection Syndrome After Colorectal Cancer Treatment

“…Major LARS negatively impacts QOL measures early on in treatment but improves with continued PFR.dysfunction can impact quality of life, be burdensome, and carry a social stigma. Over 80% of patients with LARS feel the condition negatively impacts their QOL [11].Adjuvant chemoradiation or radiation therapy, tumor height, mesorectal excision, female gender, anastomotic type, and duration of defunctioning stoma prior to reversal are associated with major LARS [2,[4][5][6][7][12][13][14]. Combined chemoradiation therapy compared to chemotherapy alone causes poorer functional outcomes and is associated with major LARS [2,14].…”

“…Over 80% of patients with LARS feel the condition negatively impacts their QOL [11].Adjuvant chemoradiation or radiation therapy, tumor height, mesorectal excision, female gender, anastomotic type, and duration of defunctioning stoma prior to reversal are associated with major LARS [2,[4][5][6][7][12][13][14]. Combined chemoradiation therapy compared to chemotherapy alone causes poorer functional outcomes and is associated with major LARS [2,14]. Though radiation treatment alone has unfavorable effects to pelvic oor muscle structure and function, a synergistic effect with chemoradiation negatively affects bowel function to a greater degree than either therapy alone [12].Treatment is largely symptom focused, including dietary modi cations, antidiarrheal medications, supplemental bulking agents, and bowel training; however, e cacy varies.…”