Li-Jen Kuo1, Yu-Ching Lin2, Chien-Hung Lai3, Yen-Kuang Lin4, Yu-Shih Huang5, Chia-Chen Hu2, Shih-Ching Chen6. 1. Division of General Surgery, Taipei Medical University Hospital, Taipei, Taiwan; Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address: kuolijen@gmail.com. 2. Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan. 3. Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. 4. Biostatistics and Research Consultation Center, Taipei Medical University, Taipei, Taiwan. 5. Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan. 6. Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. Electronic address: CSC@tmu.edu.tw.
Abstract
OBJECTIVE: To assess the efficacy and benefits of pelvic rehabilitation programs in terms of functional outcomes and quality of life for patients with fecal incontinence and defecation disorders after rectal cancer surgery. DESIGN: Prospective, observational study. SETTING: University hospital physiotherapy clinics. PARTICIPANTS: Patients (N=32) who experienced fecal incontinence after sphincter-saving surgery with the intersphincteric resection (ISR) technique and could follow and cooperate with the treatment schedule were included in the present study. INTERVENTIONS: Pelvic rehabilitation programs included electrical stimulation (ES) and biofeedback (BF). MAIN OUTCOME MEASURES: Functional results, Wexner score, and anorectal manometry were used to assess the clinical outcomes of rehabilitation treatment. RESULTS: Maximum squeeze pressure improved after rehabilitation training (P=.014). There were no statistical differences in resting pressure, resting muscle electromyography, and maximum squeeze electromyography (P=.061, P=.76, and P=.99, respectively). The mean stool frequency was 18.8 per 24 hours before the pelvic intervention program and 7.8 per 24 hours after ES and BF training (P<.001). Of the 32 patients, 27 required antidiarrheal medications before treatment, and after completion of the training, only 9 patients still needed antidiarrheal medications (P<.001). Significant improvements were observed in the Wexner score (17.74 vs 12.93; P<.001). CONCLUSIONS: Our data show that ES and BF are effective in the treatment of fecal incontinence, leading to improvement of quality of life for patients with low rectal cancer after ISR.
OBJECTIVE: To assess the efficacy and benefits of pelvic rehabilitation programs in terms of functional outcomes and quality of life for patients with fecal incontinence and defecation disorders after rectal cancer surgery. DESIGN: Prospective, observational study. SETTING: University hospital physiotherapy clinics. PARTICIPANTS: Patients (N=32) who experienced fecal incontinence after sphincter-saving surgery with the intersphincteric resection (ISR) technique and could follow and cooperate with the treatment schedule were included in the present study. INTERVENTIONS: Pelvic rehabilitation programs included electrical stimulation (ES) and biofeedback (BF). MAIN OUTCOME MEASURES: Functional results, Wexner score, and anorectal manometry were used to assess the clinical outcomes of rehabilitation treatment. RESULTS: Maximum squeeze pressure improved after rehabilitation training (P=.014). There were no statistical differences in resting pressure, resting muscle electromyography, and maximum squeeze electromyography (P=.061, P=.76, and P=.99, respectively). The mean stool frequency was 18.8 per 24 hours before the pelvic intervention program and 7.8 per 24 hours after ES and BF training (P<.001). Of the 32 patients, 27 required antidiarrheal medications before treatment, and after completion of the training, only 9 patients still needed antidiarrheal medications (P<.001). Significant improvements were observed in the Wexner score (17.74 vs 12.93; P<.001). CONCLUSIONS: Our data show that ES and BF are effective in the treatment of fecal incontinence, leading to improvement of quality of life for patients with low rectal cancer after ISR.
Authors: Lisa J Herrinton; Andrea Altschuler; Carmit K McMullen; Joanna E Bulkley; Mark C Hornbrook; Virginia Sun; Christopher S Wendel; Marcia Grant; Carol M Baldwin; Wendy Demark-Wahnefried; Larissa K F Temple; Robert S Krouse Journal: CA Cancer J Clin Date: 2016-03-21 Impact factor: 508.702
Authors: Mateusz Rubinkiewicz; Jan Witowski; Michał Wysocki; Magdalena Pisarska; Stanisław Kłęk; Andrzej Budzyński; Michał Pędziwiatr Journal: J Clin Med Date: 2019-10-01 Impact factor: 4.241