Yuki Kiyozumi1, Toshiya Nagasaki2, Shimpei Matsui3, Toshiki Mukai4, Yukiharu Hiyoshi4, Tomohiro Yamaguchi4, Takashi Akiyoshi4, Yosuke Fukunaga4. 1. Department of Surgery, Kumamoto Chuo Hospital, 1-5-1 Tainoshima, Minami-ku, Kumamoto, 862-0965, Japan. 2. Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan. toshiya.nagasaki@jfcr.or.jp. 3. Department of Surgery, Keio University School of Medicine, 35 Shinano-machi, Shinjuku-ku, Tokyo, 160-8582, Japan. 4. Gastroenterological Center, Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Abstract
PURPOSE: The present study assessed postoperative bowel dysfunction in Japanese patients with rectal cancer, including patients who underwent preoperative radiotherapy (RT). METHODS: A total of 277 rectal cancer patients who underwent primary resection were included in the analyses. A questionnaire survey was administered using the low anterior resection syndrome (LARS) score and Wexner score. Scores were determined one year after rectal surgery or diverting ileostomy closure. The LARS score was categorized as minor LARS (21-29) and major LARS (30-42). RESULTS: The proportions of patients with minor and major LARS were significantly larger and Wexner scores significantly higher in patients with distal tumors and a lower anastomosis level than in those with proximal tumors and a higher anastomosis level. Among the patients with lower rectal cancer, the proportions with minor and major LARS were similar between those with and without preoperative RT. The Wexner scores in patients with preoperative RT were significantly higher than in patients without RT. A distal tumor location and lower anastomosis level were independent risk factors of major LARS in multivariate analyses. CONCLUSION: A distal tumor location, low anastomosis level, and preoperative RT might be associated with postoperative bowel dysfunction in rectal cancer patients.
PURPOSE: The present study assessed postoperative bowel dysfunction in Japanese patients with rectal cancer, including patients who underwent preoperative radiotherapy (RT). METHODS: A total of 277 rectal cancer patients who underwent primary resection were included in the analyses. A questionnaire survey was administered using the low anterior resection syndrome (LARS) score and Wexner score. Scores were determined one year after rectal surgery or diverting ileostomy closure. The LARS score was categorized as minor LARS (21-29) and major LARS (30-42). RESULTS: The proportions of patients with minor and major LARS were significantly larger and Wexner scores significantly higher in patients with distal tumors and a lower anastomosis level than in those with proximal tumors and a higher anastomosis level. Among the patients with lower rectal cancer, the proportions with minor and major LARS were similar between those with and without preoperative RT. The Wexner scores in patients with preoperative RT were significantly higher than in patients without RT. A distal tumor location and lower anastomosis level were independent risk factors of major LARS in multivariate analyses. CONCLUSION: A distal tumor location, low anastomosis level, and preoperative RT might be associated with postoperative bowel dysfunction in rectal cancer patients.
Authors: Catherine L C Bryant; Peter J Lunniss; Charles H Knowles; Mohamed A Thaha; Christopher L H Chan Journal: Lancet Oncol Date: 2012-09 Impact factor: 41.316
Authors: Patrick Colquhoun; Roberto Kaiser; Jonathan Efron; Eric G Weiss; Juan J Nogueras; Anthony M Vernava; Steven D Wexner Journal: World J Surg Date: 2006-10 Impact factor: 3.352
Authors: Julie A Cornish; Henry S Tilney; Alexander G Heriot; Ian C Lavery; Victor W Fazio; Paris P Tekkis Journal: Ann Surg Oncol Date: 2007-04-13 Impact factor: 5.344
Authors: S Jane Henley; Elizabeth M Ward; Susan Scott; Jiemin Ma; Robert N Anderson; Albert U Firth; Cheryll C Thomas; Farhad Islami; Hannah K Weir; Denise Riedel Lewis; Recinda L Sherman; Manxia Wu; Vicki B Benard; Lisa C Richardson; Ahmedin Jemal; Kathleen Cronin; Betsy A Kohler Journal: Cancer Date: 2020-03-12 Impact factor: 6.921