Analysis of Risk Factors for Anterior Resection Syndrome of Rectal Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 LEIYa-nan ^1,2 , DINGJian-hua ¹ , ZHUOGuang-zuan ¹ , ZHAOYu-juan ¹ ,  YINShu-hui ¹

1. Department of Colorectal Surgery, The Second Artillery General Hospital, Colorectal Disease Center of PLA, Beijing 100088, China;
2. Department of Gynaecology and Obstetrics, Xuanwu Hospital of Capital Medical University, Beijing 100053, China;

Corresponding author：

YINShu-hui, Email: h008s26@hotmail.com

Keywords：

Anterior resection syndrome; Anterior resection of rectal cancer; Intersphincter resection of rectal cancer; Risk factor; Radiotherapy

DOI：

10.7507/1007-9424.20160212

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To study the risk factors affecting anterior resection syndrome of rectal cancer. Methods Sixty-seven patients with low rectal cancer who performed anus preserving operation in Second Artillery General Hospital from August 2013 to October 2014 were screened out based on inclusion and exclusion criteria. Forty-two cases received low anterior resection (LAR), 25 cases received intersphincter resection (ISR). Patients were followed-up for 1 year. The severity of anterior resection syndrome was evaluated by using score system for anterior resection syndrome. The patients' age, gender, body mass index (BMI), TNM stage, surgical mode, surgical approach, anastomotic height, prophylactic colostomy, adjuvant chemotherapy, and radiotherapy were used as research indicators, and to evaluate the impact to anterior resection syndrome. Results The single factor analysis showed that the surgical mode, preventive stoma, radiotherapy, anastomotic height, and age were related to the severity of anterior resection syndrome (P < 0.05). Logistic regression showed that the surgical mode (OR=4.506, 95% CI: 1.220, 16.640, P=0.024) and radiotherapy (OR=14. 688, 95% CI: 3.200, 67.429, P=0.001) were related to the severity of anterior resection syndrome. Conclusion Surgical mode and radiotherapy are the independent risk factors of anterior resection syndrome.

Citation： LEIYa-nan, DINGJian-hua, ZHUOGuang-zuan, ZHAOYu-juan, YINShu-hui. Analysis of Risk Factors for Anterior Resection Syndrome of Rectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2016, 23(7): 809-812. doi: 10.7507/1007-9424.20160212 Copy

1.	Pucciani F, Bologna A, Cianchi F, et al. Anorectal physiology follo-wing sphincter-saving operations for rectal cancer. Digestive Surg, 1993, 10(1): 33-38.
2.	van Duijvendijk P, Slors JF, Taat CW, et al. Prospective evaluation of anorectal function after total mesorectal excision for rectal carci-noma with or without preoperative radiotherapy. Am J Gastroenterol, 2002, 97(9): 2282-2289.
3.	Oya M, Sugamata Y, Komatsu J, et al. Poor neorectal evacuation as a cause of impaired defecatory function after low anterior resection: a study using scintigraphic assessment. Surg Today, 2002, 32(2): 111-117.
4.	NCCN practice guidelines for colorectal cancer. http://www.nccn.org2013.
5.	Juul T, Ahlberg M, Biondo S, et al. International validation of the low anterior resection syndrome score. Ann Surg, 2014, 259(4): 728-734.
6.	Scheer AS, Boushey RP, Liang S, et al. The long-term gastrointestinal functional outcomes following curative anterior resection in adults with rectal cancer: a systematic review and meta-analysis. Dis Colon Rectum, 2011, 54(12): 1589-1597.
7.	Mulsow J, Winter DC. Sphincter preservation for distal rectal cancer-a goal worth achieving at all costs? World J Gastroenterol, 2011, 17 (7): 855-861.
8.	邓罕, 李光华, 何长林, 等.直肠癌低位前切除术后吻合口水平对肛门直肠功能的影响.安徽医学, 2013, 34(12): 1807-1810.
9.	丛进春, 陈春生, 冯勇, 等.新辅助治疗对低位直肠癌经内外括约肌间切除术后肛门功能的影响.中国肿瘤临床, 2013, 40(23): 1450-1454.
10.	Emmertsen KJ, Laurberg S; Rectal Cancer Function Study Group. Impact of bowel dysfunction on quality of life after sphincter-prese-rving resection for rectal cancer. Br J Surg, 2013, 100(10): 1377-1387.
11.	Bregendahl S, Emmertsen KJ, Lous J, et al. Bowel dysfunction after low anterior resection with and without neoadjuvant therapy for rectal cancer: a population-based cross-sectional study. Colorectal Dis, 2013, 15(9): 1130-1139.
12.	Pollack J, Holm T, Cedermark B, et al. Long-term effect of preopera-tive radiation therapy on anorectal function. Dis Colon Rectum, 2006, 49(3): 345-352.
13.	Lange MM, den Dulk M, Bossema E R, et al. Risk factors for faecal incontinence after rectal cancer treatment. Br J Surg, 2007, 94(10): 1278-1284.
14.	Peeters KC, van de Velde CJ, Leer JW, et al. Late side effects of short-course preoperative radiotherapy combined with total mesorectal excision for rectal cancer: increased bowel dysfunction in irradiated patients--a Dutch colorectal cancer group study. J Clin Oncol, 2005, 23(25): 6199-6206.
15.	Schiessel R, Karnel-Hanusch J, Herbst F, et al. Intersphincteric resection for low rectal tumours. Br J Surg, 1994, 81(9): 1376-1378.
16.	Konanz J, Herrle F, Weiss C, et al. Quality of life of patients after low anterior, intersphincteric, and abdominoperineal resection for rectal cancer-a matched-pair analysis. Int J Colorectal Dis, 2013, 28(5): 679-688.
17.	Martin ST, Heneghan HM, Winter DC. Systematic review of outco-mes after intersphincteric resection for low rectal cancer. Br J Surg, 2012, 99(5): 603-612.
18.	Ziv Y, Gimelfarb Y, Igov I. Post anterior rectal resection syndrome-a retrospective multicentre study. Colorectal Dis, 2013, 15(6): e317-e322.
19.	Wells CI, Vather R, Chu MJ, et al. Anterior resection syndrome-a risk factor analysis. J Gastrointest Surg, 2015, 19(2): 350-359.
20.	Kim KH, Yu CS, Yoon YS, et al. Effectiveness of biofeedback therapy in the treatment of anterior resection syndrome after rectal cancer surgery. Dis Colon Rectum, 2011, 54(9): 1107-1113.
21.	Michelsen HB, Buntzen S, Krogh K, et al. Rectal volume tolerability and anal pressures in patients with fecal incontinence treated with sacral nerve stimulation. Dis Colon Rectum, 2006, 9(7): 1039-1044.
22.	Michelsen HB, Christensen P, Krogh K, et al. Sacral nerve stimula-tion for faecal incontinence alters colorectal transport. Br J Surg, 2008, 95(6): 779-784.

1. Pucciani F, Bologna A, Cianchi F, et al. Anorectal physiology follo-wing sphincter-saving operations for rectal cancer. Digestive Surg, 1993, 10(1): 33-38.
2. van Duijvendijk P, Slors JF, Taat CW, et al. Prospective evaluation of anorectal function after total mesorectal excision for rectal carci-noma with or without preoperative radiotherapy. Am J Gastroenterol, 2002, 97(9): 2282-2289.
3. Oya M, Sugamata Y, Komatsu J, et al. Poor neorectal evacuation as a cause of impaired defecatory function after low anterior resection: a study using scintigraphic assessment. Surg Today, 2002, 32(2): 111-117.
4. NCCN practice guidelines for colorectal cancer. http://www.nccn.org2013.
5. Juul T, Ahlberg M, Biondo S, et al. International validation of the low anterior resection syndrome score. Ann Surg, 2014, 259(4): 728-734.
6. Scheer AS, Boushey RP, Liang S, et al. The long-term gastrointestinal functional outcomes following curative anterior resection in adults with rectal cancer: a systematic review and meta-analysis. Dis Colon Rectum, 2011, 54(12): 1589-1597.
7. Mulsow J, Winter DC. Sphincter preservation for distal rectal cancer-a goal worth achieving at all costs? World J Gastroenterol, 2011, 17 (7): 855-861.
8. 邓罕, 李光华, 何长林, 等.直肠癌低位前切除术后吻合口水平对肛门直肠功能的影响.安徽医学, 2013, 34(12): 1807-1810.
9. 丛进春, 陈春生, 冯勇, 等.新辅助治疗对低位直肠癌经内外括约肌间切除术后肛门功能的影响.中国肿瘤临床, 2013, 40(23): 1450-1454.
10. Emmertsen KJ, Laurberg S; Rectal Cancer Function Study Group. Impact of bowel dysfunction on quality of life after sphincter-prese-rving resection for rectal cancer. Br J Surg, 2013, 100(10): 1377-1387.
11. Bregendahl S, Emmertsen KJ, Lous J, et al. Bowel dysfunction after low anterior resection with and without neoadjuvant therapy for rectal cancer: a population-based cross-sectional study. Colorectal Dis, 2013, 15(9): 1130-1139.
12. Pollack J, Holm T, Cedermark B, et al. Long-term effect of preopera-tive radiation therapy on anorectal function. Dis Colon Rectum, 2006, 49(3): 345-352.
13. Lange MM, den Dulk M, Bossema E R, et al. Risk factors for faecal incontinence after rectal cancer treatment. Br J Surg, 2007, 94(10): 1278-1284.
14. Peeters KC, van de Velde CJ, Leer JW, et al. Late side effects of short-course preoperative radiotherapy combined with total mesorectal excision for rectal cancer: increased bowel dysfunction in irradiated patients--a Dutch colorectal cancer group study. J Clin Oncol, 2005, 23(25): 6199-6206.
15. Schiessel R, Karnel-Hanusch J, Herbst F, et al. Intersphincteric resection for low rectal tumours. Br J Surg, 1994, 81(9): 1376-1378.
16. Konanz J, Herrle F, Weiss C, et al. Quality of life of patients after low anterior, intersphincteric, and abdominoperineal resection for rectal cancer-a matched-pair analysis. Int J Colorectal Dis, 2013, 28(5): 679-688.
17. Martin ST, Heneghan HM, Winter DC. Systematic review of outco-mes after intersphincteric resection for low rectal cancer. Br J Surg, 2012, 99(5): 603-612.
18. Ziv Y, Gimelfarb Y, Igov I. Post anterior rectal resection syndrome-a retrospective multicentre study. Colorectal Dis, 2013, 15(6): e317-e322.
19. Wells CI, Vather R, Chu MJ, et al. Anterior resection syndrome-a risk factor analysis. J Gastrointest Surg, 2015, 19(2): 350-359.
20. Kim KH, Yu CS, Yoon YS, et al. Effectiveness of biofeedback therapy in the treatment of anterior resection syndrome after rectal cancer surgery. Dis Colon Rectum, 2011, 54(9): 1107-1113.
21. Michelsen HB, Buntzen S, Krogh K, et al. Rectal volume tolerability and anal pressures in patients with fecal incontinence treated with sacral nerve stimulation. Dis Colon Rectum, 2006, 9(7): 1039-1044.
22. Michelsen HB, Christensen P, Krogh K, et al. Sacral nerve stimula-tion for faecal incontinence alters colorectal transport. Br J Surg, 2008, 95(6): 779-784.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of Risk Factors for Anterior Resection Syndrome of Rectal Cancer

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content