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https://hdl.handle.net/2440/123961
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Type: | Journal article |
Title: | Patient reported and physician recorded bowel dysfunction following colorectal resection and radical cystectomy: a prospective, comparative study |
Author: | Ng, K.-S. Gladman, M.A. |
Citation: | Colorectal Disease, 2020; 22(10):1336-1347 |
Publisher: | Wiley |
Issue Date: | 2020 |
ISSN: | 1462-8910 1463-1318 |
Statement of Responsibility: | Kheng-Seong Ng, Marc A Gladman |
Abstract: | AIM: Bowel dysfunction following anterior resection (AR) is termed 'low anterior resection syndrome (LARS)'. It is unclear whether such dysfunction occurs following other bowel/pelvic operations as well. This study aimed to characterise 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). RESULTS: Of 743 eligible patients, 70% participated (AR: n=338, mean age 69.6yrs [SD11.9], 59% male; RH: n=150, 75.8yrs [SD10.5], 54% male; RC: n=34, 71.1yrs [SD14.1], 71% male). 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 following RH (35%) and RC (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 LARS 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. |
Keywords: | Humans Rectal Neoplasms Syndrome Postoperative Complications Colectomy Cystectomy Prospective Studies Quality of Life Aged Physicians Female Male Patient Reported Outcome Measures |
Rights: | This article is protected by copyright. All rights reserved [Wiley] |
DOI: | 10.1111/codi.15041 |
Grant ID: | NHMRC |
Published version: | http://dx.doi.org/10.1111/codi.15041 |
Appears in Collections: | Aurora harvest 8 Medicine publications |
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