scholarly journals Low anterior resection syndrome score among Nepalese population undergoing lower anterior resection for rectal carcinoma

2018 ◽  
Vol 7 (2) ◽  
pp. 59-63
Author(s):  
Dhiresh Kumar Maharjan ◽  
SC Acharya ◽  
PB Thapa

Background: With more sphincters preserving surgery being performed for distal rectal cancer, these have been associated with clusters of symptoms experienced by the patient after reversal of diverting ileostomy collectively known as low anterior resection syndrome.Objective: Our objective is to know incidence of Lower Anterior Resection (LAR) syndrome in different phase of time in our context using low anterior resection symptom score translate in Nepali language.Methodology: This is an observational descriptive study conducted at Department of Surgery, Kathmandu Medical College and Department of Clinical Oncology, Bir Hospital, Kathmandu from Jan 2015 till Jan 2017. All patients who had undergone low and ultra low anterior resection for middle and low rectal cancer respectively after a long course of neo adjuvant concurrent chemo radiotherapy, having undergone a reversal of diverting ileostomy after 6 weeks of primary surgery were included. A Nepalese version of low anterior resection score was developed after translation from English and scoring was done on 30th day, at the end of 6 months and 1 year postoperative following reversal of ileostomy.Results: Out of 43 consecutive patient 100 % of patients had features of major low anterior resection syndrome during 30 days of ileostomy reversal. However, 46.5% patient showed major low anterior resection syndrome during 6 months of follow up and that decreased to 34.9% showed major LAR syndrome upon one year of follow up.Conclusions: The Low anterior resection syndrome score converted in Nepali language is feasible to use and helps in comparing the functional results of reconstruction after low or ultralow anterior resection and our study have shown improvement in score with time. Journal of Kathmandu Medical College,Vol. 7, No. 2, Issue 24, Apr.-Jun., 2018, page: 59-63 

Author(s):  
Hemn Hussain Kaka Ali ◽  
Qalandar Hussein Abdulkarim ◽  
Karzan Seerwan ◽  
Barham M. M .Salih

This is a multi-center retrospective study of patients underwent low anterior resection for rectal cancer. Ileostomy had been done to protect low lying Colo-rectal anastomosis, closure of ileostomy had been delayed in some patients due to patient own will, surgical complications (anastomotic leak) or coarse of chemotherapy. This study aimed to find the effect of temporary ileostomy on post-operative bowel defunction which is called Low anterior resection syndrome (LARS), and include; urgency, difficulty in emptying of bowel, and incontinence for feces and flatus.  A total of 50 patients included in this study, the age ranges from the 19 to 80 years old with a mean age of 51.96 years. The total number of males was (33, %66). Majority of patients were overweight (21, 42%). The distance of tumors from the anal verge were less than 10 cm in (31,62%). The mean duration of fecal diversion was 7.17 months. Loop ileostomy were closed before six months in (27,54%). The mean duration of diversion of patients developed no LARS was 6.87 months which is shorter than those of developed LARS (7.31). Lower BMI patients are more prone to develop LARS, while Obese patients are more susceptible to develop major LARS. Nineteen cases developed LARS among those patient’s ileostomy closed before six months, and 15 cases developed LARS in those ileostomies closed after six months.    


2017 ◽  
Vol 25 (4) ◽  
pp. 642-654
Author(s):  
E. P. Kulikov ◽  
Yu. D. Kaminsky ◽  
S. V. Klevcova

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.


2019 ◽  
Vol 28 (3) ◽  
pp. 1199-1206 ◽  
Author(s):  
Ali Bohlok ◽  
Camille Mercier ◽  
Fikri Bouazza ◽  
Maria Gomez Galdon ◽  
Luigi Moretti ◽  
...  

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