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Patient‐reported and physician‐recorded bowel dysfunction following colorectal resection and radical cystectomy: a prospective, comparative study
Author(s) -
Ng K.S.,
Gladman M. A.
Publication year - 2020
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.15041
Subject(s) - medicine , constipation , concomitant , quality of life (healthcare) , prospective cohort study , bowel function , defecation , cystectomy , colorectal cancer , gastroenterology , surgery , cancer , bladder cancer , nursing
Abstract Aim Bowel dysfunction following anterior resection (AR) is termed low anterior resection syndrome. It is unclear whether such dysfunction occurs following other bowel/pelvic operations as well. This study aimed to characterize and compare bowel dysfunction following AR, right hemicolectomy (RH) and radical cystectomy (RC). Method A prospective study of consecutive patients undergoing AR, RH and RC (2002–2012) was performed at a tertiary referral centre in Sydney, Australia. Outcome measures included (i) patient‐reported satisfaction with bowel function, self‐described bowel function and self‐reported change in bowel function; (ii) objective assessment of bowel function using validated criteria to identify symptoms and stratify patients into those with constipation and/or faecal incontinence (FI); and (iii) health‐related quality of life (SF‐36v2 Health Survey). Results Of 743 eligible patients, 70% participated [AR, n = 338, mean age 69.6 years (SD 11.9), 59% men; RH, n = 150, 75.8 years (SD 10.5), 54% men; RC, n = 34, 71.1 years (SD 14.1), 71% men]. AR patients were three times more likely to report change in bowel function post‐surgery and self‐judged their bowel function as abnormal more frequently (64%) than RH patients (35%) and RC patients (35%) ( P < 0.01). AR patients were four times more likely to meet criteria for concomitant constipation and FI. Patients with concomitant constipation and FI had lower physical and mental SF‐36v2 scores ( P < 0.001). Conclusion Bowel dysfunction occurred after RH and RC but rates were higher following AR. This suggests that low anterior resection syndrome occurs due to a direct impact of partial/complete loss of the rectum rather than just due to loss of bowel length and/or the consequence(s) of pelvic dissection.