scholarly journals Impact of a defunctioning ileostomy and time to stoma closure on bowel function after low anterior resection for rectal cancer: a systematic review and meta-analysis

2021 ◽  
Author(s):  
I. Vogel ◽  
N. Reeves ◽  
P. J. Tanis ◽  
W. A. Bemelman ◽  
J. Torkington ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Bowel Function ◽  
Ileostomy Closure ◽  
Stoma Closure ◽  
Defunctioning Ileostomy

Abstract Background Impaired bowel function after low anterior resection (LAR) for rectal cancer is a frequent problem with a major impact on quality of life. The aim of this study was to assess the impact of a defunctioning ileostomy, and time to ileostomy closure on bowel function after LAR for rectal cancer. Methods We performed a systematic review based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. Comprehensive literature searches were conducted using PubMed, Embase and Cochrane databases for articles published from 1989 up to August 2019. Analysis was performed using Review Manager (version 5.3) using a random-effects model. Results The search yielded 11 studies (1400 patients) that reported on functional outcome after LAR with at least 1 year follow-up, except for one study. Five scales were used: the Low Anterior Resection Syndrome (LARS) score, the Wexner score, the Memorial Sloan Kettering Cancer Centre Bowel Function Instrument, the Fecal Incontinence Quality of Life scale, and the Hallbook questionnaire. Based on seven studies, major LARS occurred more often in the ileostomy group (OR 2.84, 95% CI, 1.70–4.75, p < 0.0001: I2 = 60%, X2 = 0.02). Based on six studies, a longer time to stoma closure increased the risk of major LARS with a mean difference in time to closure of 2.39 months (95% CI, 1.28–3.51, p < 0.0001: I2 = 21%, X2 = 0.28) in the major vs. no LARS group. Other scoring systems could not be pooled, but presence of an ileostomy predicted poorer bowel function except with the Hallbook questionnaire. Conclusions The risk of developing major LARS seems higher with a defunctioning ileostomy. A prolonged time to ileostomy closure seems to reinforce the negative effect on bowel function; therefore, early reversal should be an important part of the patient pathway.

Quality of Life and Timing of Stoma Closure in Patients With Rectal Cancer Undergoing Low Anterior Resection With Diverting Stoma

2016 ◽  
Vol 59 (4) ◽  
pp. 281-290 ◽  
Author(s):  
Florian Herrle ◽  
Flavius Sandra-Petrescu ◽  
Christel Weiss ◽  
Stefan Post ◽  
Norbert Runkel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Stoma Closure ◽  
Diverting Stoma

scholarly journals Quality of life after rectal cancer surgery (systematic review)

2021 ◽  
Vol 20 (1) ◽  
pp. 59-67
Author(s):  
A. B. Serebriy ◽  
E. A. Khomyakov ◽  
I. O. Nafedzov ◽  
O. Yu. Fomenko ◽  
E. G. Rybakov
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Life Quality ◽  
Cancer Surgery ◽  
Rectal Cancer Surgery ◽  
Low Anterior Resection Syndrome

Aim: search for modifiable and unmodifiable risk factors affecting the quality of life of patients after rectal cancer surgery.Materials and methods: the literature search was done according to the keywords: quality of life, rectal cancer, low anterior resection syndrome. Twelve prospective randomized studies, 2 cohort studies, and 2 meta-analyses are included in the study. The quality of life was assessed in the analyzed studies by using questionnaires for cancer patients and updated questionnaires for colorectal cancer: EORTC QLQ-CR29, QLQ-C30, QLQ-CR38, BIQ.Results: the literary data on influence of gender, age, surgery, stoma, and chemoradiotherapy on life quality of patients after rectal cancer surgery was analyzed.Conclusion: the most significant factor affecting the life quality of patients with rectal cancer is a violation of the body image if it is necessary to form the stoma on the anterior abdominal wall. The manifestations of the low anterior resection syndrome and the urination problems are significant risk factors in the case of restoration of bowel continuity.

scholarly journals Surgical correction of functional disorders in performing sphincterosafing operations for rectal cancer (literature review)

2017 ◽  
Vol 25 (4) ◽  
pp. 642-654
Author(s):  
E. P. Kulikov ◽  
Yu. D. Kaminsky ◽  
S. V. Klevcova
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Malignant Tumors ◽  
Functional Results ◽  
Surgical Correction ◽  
Low Anterior Resection Syndrome ◽  
Cumulative Function

For many decades the main goal of oncologists was to increase life expectancy of patients with malignant tumors, without paying due attention to quality of life. Currently, the goals of patients’ treatment with rectal cancer are to cure, to minimize the risk of local recurrence, preserve the normal course of intestine, to optimize it's function and to ensure quality of life. For a long time, the standard surgical treatment of patients with low rectal cancer was abdominoperineal extirpation, but recently sphincterosafing operations have seen a widespread introduction in surgical practice. However, functional results after these types of operations don't always meet the expectations of surgeons and patients. In the postoperative period, patients often develop a syndrome of low anterior resection, characterized by frequent bowel movements, repeated, prolonged and incomplete evacuation of bowel and the imperative urge to defecate. The manifestation of this syndrome can significantly impair the quality of patient's life and reduce to nothing the efforts of the surgeon to preserve the sphincter of the rectum. For surgical correction of low anterior resection syndrome, various types of colonic reservoir anastomoses have been proposed. The purpose of formation of colonic reservoirs is to increase the cumulative function of intestine. However, the existing methods have several disadvantages related to technical complications and the risk of developing evacuation dysfunction, which is the reason for search the new ways of optimization of anastomoses when performing sphincterotomy operations for cancer of the rectum.

The burden of low anterior resection syndrome on quality of life in patients with mid or low rectal cancer

2019 ◽  
Vol 28 (3) ◽  
pp. 1199-1206 ◽  
Author(s):  
Ali Bohlok ◽  
Camille Mercier ◽  
Fikri Bouazza ◽  
Maria Gomez Galdon ◽  
Luigi Moretti ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Low Rectal Cancer ◽  
Low Anterior Resection Syndrome ◽  
Anterior Resection Syndrome

Đánh giá chất lượng cuộc sống của bệnh nhân ung thư trực tràng trên và giữa được điều trị phẫu thuật nội soi cắt trực tràng trước thấp

2020 ◽  
Author(s):  
Thong Tran Ngoc
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Anterior Resection ◽  
Low Anterior Resection ◽  
Overall Survival Rate ◽  
Central Hospital ◽  
Laparoscopic Low Anterior Resection ◽  
The Mean

Introduction: Evaluation of the quality of life of patients with upper and middle rectal cancer treated with laparoscopic low anterior resection. Material and method: Prospective and previous research from 1/2013 to 9/2019 at Hue central hospital, a laparoscopic low anterior resection was performed in 86 patients with upper and mid rectal cancer. Result: There were 40 males and 45 females with the mean age of 62,95 ± 13,13; no conversion, have seven cases anastomotic leakage. Mean follow-up duration 60 months: have five cases local recurrence (5,9%), the overall survival rate after 5 years was 45%. Quality of Life of Patients is quiet good. Conclusion: Laparoscopic low anterior resection for treatment upper and mid rectal cancer is safe and effective, quality of life of patient is quite good.

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