Colonic J-pouch reconstruction versus straight colorectal anastomosis after low anterior resection for rectal cancer: impact on anastomotic leak, bowel function and quality of life. A multicentre prospective randomised trial

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.

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Impact of short-course radiotherapy and low anterior resection on quality of life and bowel function in primary rectal cancer

The American Journal of Surgery ◽

10.1016/j.amjsurg.2007.12.034 ◽

2008 ◽

Vol 195 (5) ◽

pp. 611-615 ◽

Cited By ~ 24

Author(s):

Ariana Murata ◽

Carl J. Brown ◽

Manoj Raval ◽

P. Terry Phang

Keyword(s):

Quality Of Life ◽

Rectal Cancer ◽

Anterior Resection ◽

Low Anterior Resection ◽

Bowel Function ◽

Primary Rectal Cancer ◽

Short Course ◽

Short Course Radiotherapy

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Retzius-sparing vs. conventional robotic assisted radical prostatectomy in a prospective, randomised trial – early functional outcome and quality of life

European Urology ◽

10.1016/s0302-2838(21)01473-1 ◽

2021 ◽

Vol 79 ◽

pp. S1562

Author(s):

V.S. Schütz ◽

M Güttlein ◽

D. Würkner ◽

L. Hofer ◽

P. Reimold ◽

...

Keyword(s):

Quality Of Life ◽

Radical Prostatectomy ◽

Functional Outcome ◽

Randomised Trial ◽

Robotic Assisted ◽

Prospective Randomised Trial ◽

Early Functional Outcome ◽

Robotic Assisted Radical Prostatectomy

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Quality of life after rectal cancer surgery (systematic review)

Koloproktologia ◽

10.33878/2073-7556-2021-20-1-59-67 ◽

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.

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A Randomised Controlled Trial of the Effect of Esmarch Tourniquet Use on Blood Loss, Bruising and Quality of Life in Elective Varicose Vein Surgery

Phlebology The Journal of Venous Disease ◽

10.1177/026835550201700104 ◽

2002 ◽

Vol 17 (1) ◽

pp. 10-12

Author(s):

A. Fowler ◽

M. Stechman ◽

D. Mitchell

Keyword(s):

Quality Of Life ◽

Blood Loss ◽

Varicose Vein ◽

Controlled Trial ◽

Randomised Trial ◽

Varicose Vein Surgery ◽

Clinical Value ◽

Prospective Randomised Trial ◽

Randomised Controlled

Objective: To assess the effect of tourniquet use on bleeding, bruising and quality of life in varicose vein surgery. Method: A prospective randomised trial of 49 patients undergoing varicose vein surgery was carried out. All patients were having single leg surgery as a day case. Blood loss was assessed by weighing swabs. Bruising was measured at 10 days, and quality of life assessed with SF36 questionaires. Synthesis: In the tourniquet group blood loss was significantly reduced but not the area of bruising. The SF36 scores showed deterioration in the non-tourniquet group at 10 days but this was not present at 6 weeks. We saw no complications of tourniquet use but the study was limited by disappointing recruitment reducing the power. Conclusion: Tourniquet use may be of clinical value. A larger study is required to assess the significance.

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