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Original Article
Quality of Life After a Low Anterior Resection for Rectal Cancer in Elderly Patients
Verena N.N. Kornmann, Marieke S. Walma, Marnix A.J. de Roos, Djamila Boerma, Henderik L. van Westreenen
Ann Coloproctol. 2016;32(1):27-32.   Published online February 29, 2016
DOI: https://doi.org/10.3393/ac.2016.32.1.27
  • 6,956 View
  • 63 Download
  • 12 Web of Science
  • 12 Citations
AbstractAbstract PDF
Purpose

Fecal incontinence is a major concern, and its incidence increases with age. Quality of life may decrease due to fecal incontinence after both sphincter-saving surgery and a rectal resection with a permanent stoma. This study investigated quality of life, with regard to fecal incontinency, in elderly patients after rectal-cancer surgery.

Methods

All patients who underwent elective rectal surgery with anastomosis for rectal cancer between December 2008 and June 2012 at two Dutch hospitals were eligible for inclusion. The Wexner and the fecal incontinence quality of life (FIQoL) scores were collected. Young (<70 years of age) and elderly (≥70 years of age) patients were compared.

Results

Seventy-nine patients were included, of whom 19 were elderly patients (24.1%). All diverting stomas that had been placed (n = 60, 75.9%) had been closed at the time of the study. There were no differences in Wexner or FIQoL scores between the young and the elderly patients. Also, there were no differences between patients without a diverting stoma and patients in whom bowel continuity had been restored. Elderly females had significantly worse scores on the FIQoL subscales of coping/behavior (P = 0.043) and depression/self-perception (P = 0.004) than young females. Elderly females scored worse on coping/behavior (P = 0.010) and depression/self-perception (P = 0.036) than elderly males. Young and elderly males had comparable scores.

Conclusion

Quality of life with regard to fecal incontinency is worse in elderly females after sphincter-preserving surgery for rectal cancer. Patients should be informed of this impact, and a definite stoma may be considered in this patient group.

Citations

Citations to this article as recorded by  
  • Analyzing quality of life after low anterior resection for rectal cancer
    Seyed Mostafa Meshkati Yazd, Reza Shahriarirad, Shayan Almasi, Darioush Naddaffard, Saman Sheikhi, Imana Mosayebi, Kimia Goudarzi, Seyed Mohsen Ahmadi Tafti, Behnam Behboudi, Alireza Kazemeini, Mohammad Reza Keramati
    Irish Journal of Medical Science (1971 -).2024; 193(6): 2643.     CrossRef
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    ANZ Journal of Surgery.2022; 92(3): 390.     CrossRef
  • Functional Bowel Complaints and the Impact on Quality of Life After Colorectal Cancer Surgery in the Elderly
    Stijn H. J. Ketelaers, Maarten van Heinsbergen, Ricardo G. Orsini, F. Jeroen Vogelaar, Joop L. M. Konsten, Grard A. P. Nieuwenhuijzen, Harm J. T. Rutten, Jacobus W. A. Burger, Johanne G. Bloemen
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    European Journal of Oncology Nursing.2021; 52: 101934.     CrossRef
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  • The Artificial Bowel Sphincter in the Treatment of Fecal Incontinence, Long-term Complications
    Aart A. van der Wilt, Stéphanie O. Breukink, Rosel Sturkenboom, Laurents P. Stassen, Cornelius G. Baeten, Jarno Melenhorst
    Diseases of the Colon & Rectum.2020; 63(8): 1134.     CrossRef
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    Evan Lapinsky, Lillian C. Man, Amy R. MacKenzie
    Current Oncology Reports.2019;[Epub]     CrossRef
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    European Journal of Surgical Oncology.2018; 44(7): 1031.     CrossRef
  • Late assessment of quality of life in patients with rectal carcinoma: comparison between sphincter preservation and definitive colostomy
    Mariane Messias Reis Lima Silva, Samuel Aguiar Junior, Juliana de Aguiar Pastore, Érica Maria Monteiro Santos, Fábio de Oliveira Ferreira, Ranyell Matheus S. B. Spencer, Vinicius F. Calsavara, Wilson Toshihiko Nakagawa, Ademar Lopes
    International Journal of Colorectal Disease.2018; 33(8): 1039.     CrossRef
  • Chirurgische Therapie des Karzinoms des unteren Rektumdrittels
    A. D. Rink
    coloproctology.2017; 39(6): 411.     CrossRef
  • Quality of Life After a Low Anterior Resection in Elderly Patients
    Byung Chun Kim
    Annals of Coloproctology.2016; 32(1): 5.     CrossRef
Erratum
Erratum
Marieke S. Walma, Verena N. N. Kornmann, Djamila Boerma, Marnix A. J. de Roos, Henderik L. van Westreenen
Ann Coloproctol. 2015;31(4):167-167.   Published online August 31, 2015
DOI: https://doi.org/10.3393/ac.2015.31.4.167
  • 3,786 View
  • 17 Download
PDF
Original Article
Predictors of Fecal Incontinence and Related Quality of Life After a Total Mesorectal Excision With Primary Anastomosis for Patients With Rectal Cancer
Marieke S. Walma, Verena N. N. Kornmann, Djamila Boerma, Marnix A. J. de Roos, Henderik L. van Westreenen
Ann Coloproctol. 2015;31(1):23-28.   Published online February 28, 2015
DOI: https://doi.org/10.3393/ac.2015.31.1.23
  • 7,640 View
  • 48 Download
  • 44 Web of Science
  • 42 Citations
AbstractAbstract PDF
Purpose

After total mesorectal excision (TME) with primary anastomosis for patients with rectal cancer, the quality of life (QoL) may be decreased due to fecal incontinence. This study aimed to identify predictors of fecal incontinence and related QoL.

Methods

Patients who underwent TME with primary anastomosis for rectal cancer between December 2008 and June 2012 completed the fecal incontinence quality of life scale (FIQoL) and Wexner incontinence score. Factors associated with these scores were identified using a linear regression analysis.

Results

A total of 80 patients were included. Multivariate analysis identified a diverting ileostomy (n = 58) as an independent predictor of an unfavorable outcome on the FIQoL subscale coping/behavior (P = 0.041). Ileostomy closure within and after 3 months resulted in median Wexner scores of 5.0 (interquartile range [IQR], 2.5-8.0) and 10.5 (IQR, 6.0-13.8), respectively (P < 0.001). The median FIQoL score was 15.0 (IQR, 13.1-16.0) for stoma closure within 3 months versus 12.0 (IQR, 10.5-13.9) for closure after 3 months (P = 0.001).

Conclusion

A diverting ileostomy is a predictor for an impaired FIQoL after a TME for rectal cancer. Stoma reversal within 3 months showed better outcomes than reversal after 3 months. Patients with a diverting ileostomy should be informed about the impaired QoL, even after stoma closure.

Citations

Citations to this article as recorded by  
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    Arturo Cirera de Tudela, Franco Marinello, Eloy Espín Basany
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    Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie.2025; 150(02): 140.     CrossRef
  • Effectiveness of pelvic floor muscle training in the recovery of patients after low anterior resection: A systematic review and meta-analysis
    Min Jeong Kim, Seonmi Yeom, Young Man Kim
    European Journal of Oncology Nursing.2025; 77: 102918.     CrossRef
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    Virginia Vargiu, Andrea Rosati, Francesco Santullo, Matteo Figà, Giovanni Esposito, Silvio Andrea Russo, Guido Lancellotti, Carlo Abatini, Claudio Lodoli, Matteo Loverro, Diana Giannarelli, Barbara Costantini, Angelica Naldini, Anna Fagotti
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    L. Blanco Terés, C. Cerdán Santacruz, A. Correa Bonito, L. Delgado Búrdalo, A. Rodríguez Sánchez, E. Bermejo Marcos, J. García Septiem, E. Martín Pérez
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    Tedman Cheuk‐Yiu Chau, Hung Nguyen, Iain K. Robertson, Xavier Harvey, Brendan Tan, Mitchell Tan, Caroline M. Yang
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  • The Effect of a Temporary Stoma on Long-term Functional Outcomes Following Surgery for Rectal Cancer
    Sanne J. Verkuijl, Jara E. Jonker, Edgar J.B. Furnée, Wendy Kelder, Christiaan Hoff, Daniel A. Hess, Fennie Wit, Ronald J. Zijlstra, Monika Trzpis, Paul M.A. Broens
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    Annals of Coloproctology.2024; 40(1): 27.     CrossRef
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    Dilek Aktaş, Sema Koçaşlı, Zehra Göçmen Baykara
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    Anna Cecilie Lefèvre, Eva Serup-Hansen, Katrine Smedegaard Storm, Karen Lycke Wind, Camilla Kronborg, Karen-Lise Garm Spindler
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Review
Pelvic Floor Rehabilitation to Improve Functional Outcome After a Low Anterior Resection: A Systematic Review
Wilhelmina S Visser, Wouter W te Riele, Djamila Boerma, Bert van Ramshorst, Henderik L van Westreenen
Ann Coloproctol. 2014;30(3):109-114.   Published online June 23, 2014
DOI: https://doi.org/10.3393/ac.2014.30.3.109
  • 12,765 View
  • 239 Download
  • 91 Web of Science
  • 104 Citations
AbstractAbstract PDF
Purpose

Impaired functional outcome is common after a low anterior resection (LAR). Pelvic floor rehabilitation (PFR) might improve functional outcome after a LAR. The aim of this systematic review is to evaluate the effectiveness of PFR in improving functional outcome.

Methods

PubMed, Embase, and the Cochrane Library were searched using the terms fecal incontinence, colorectal neoplasm/surgery, LAR, rectal cancer, anterior resection syndrome, bowel habit, pelvic floor, training, therapy, physical therapy, rehabilitation and biofeedback. Of the 125 identified records, 5 articles were included.

Results

The 5 included studies reported on 321 patients, of which 286 patients (89%) underwent pelvic floor training. Three studies included patients with anterior resection syndrome after a LAR while the remaining studies included a series of patients after a LAR. Functional outcome was mostly assessed by using the Wexner incontinence scale. Quality of life was assessed in one study, and in three studies, rectal manometry was performed. After PFR, the functional outcome was improved in four studies, as was the quality of life.

Conclusion

This systematic review demonstrated that PFR is useful for improving the functional outcome after a LAR. The data are extracted from studies of limited quality, but the available evidence points to the effectiveness of the procedure.

Citations

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    Sanne J. Verkuijl, Jara E. Jonker, Edgar J.B. Furnée, Wendy Kelder, Christiaan Hoff, Daniel A. Hess, Fennie Wit, Ronald J. Zijlstra, Monika Trzpis, Paul M.A. Broens
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